JP6266695B2 - Blood purification apparatus and priming method thereof - Google Patents

Description

  The present invention relates to a blood purification apparatus for purifying a patient's blood while circulating it outside the body, and a priming method thereof.

  As a conventional dialysis apparatus as a blood purification apparatus, for example, as disclosed in Patent Document 1, a blood circuit for circulating a patient's blood extracorporeally, and a blood purification means such as a dialyzer for purifying blood flowing through the blood circuit And a priming solution supply means capable of supplying a priming solution such as physiological saline to the blood circuit, and an overflow line extending from the air trap chamber connected to the blood circuit. Proposals have been made to perform blood purification treatment with a dialyzer while circulating.

  In such a conventional dialysis apparatus, priming for filling a priming solution into a blood circuit or the like is performed before dialysis treatment (before blood purification treatment). Such priming is usually performed by supplying the priming liquid to the blood circuit by the priming liquid supply means and filling the blood circuit, and overflowing the priming liquid at the overflow line and discharging it to the outside.

JP 2010-273893 A

  In the conventional blood purification apparatus, when blood is extracorporeally circulated in the blood circuit to perform blood purification treatment after priming, blood flowing through the blood circuit may come into contact with the priming liquid remaining in the overflow line. was there. In that case, when the blood circuit and the overflow line are removed from the apparatus main body after the blood purification treatment, the priming liquid mixed with blood may be discharged from the overflow line and scattered around. Furthermore, the above-described problem may occur in a blood purification apparatus having a priming liquid distribution line including a priming liquid supply line for supplying the priming liquid, as well as the overflow line for discharging the priming liquid.

  The present invention has been made in view of such circumstances, and blood purification that can reliably prevent the priming liquid mixed with blood from the priming liquid distribution line from splashing around after blood purification treatment. It is to provide an apparatus and a priming method thereof.

  According to the first aspect of the present invention, there is provided a blood circuit having an arterial blood circuit and a venous blood circuit capable of extracorporeally circulating a patient's blood, and the blood connected between the arterial blood circuit and the venous blood circuit. Blood purifying means for purifying blood flowing through the circuit, a priming liquid distribution line connected to the blood circuit and capable of circulating a priming liquid, and the blood purifying means circulating blood extracorporeally in the blood circuit And a control means for supplying or discharging priming fluid to or from the blood circuit via the priming fluid distribution line before performing blood purification treatment by purifying the blood circuit. The priming solution in the priming solution distribution line is after the priming and before the blood purification treatment. Characterized in that that can be replaced with air.

  According to a second aspect of the present invention, in the blood purification apparatus according to the first aspect, the priming liquid flow line is connected to an air trap chamber for gas-liquid separation formed in the blood circuit, and the air trap The liquid level adjusting means is configured to adjust the liquid level by supplying or discharging air to or from the chamber, and the control means operates the liquid level adjusting means to supply the air by operating the liquid level adjusting means. The priming liquid in the liquid distribution line can be replaced with air.

  According to a third aspect of the present invention, in the blood purification apparatus according to the first aspect, the priming fluid distribution line is connected to an air trap chamber for gas-liquid separation formed in the blood circuit, and the control means. Is characterized in that the priming liquid in the priming liquid distribution line can be sucked into the air trap chamber and replaced with air by operating a pump or a solenoid valve provided in the blood purification apparatus.

  According to a fourth aspect of the present invention, in the blood purification apparatus according to any one of the first to third aspects, the priming fluid distribution line is an overflow line that can discharge the priming fluid from the blood circuit during priming. It is characterized by comprising.

  According to a fifth aspect of the present invention, in the blood purification apparatus according to any one of the first to third aspects, the priming liquid distribution line can supply a priming liquid into the blood circuit during priming. It consists of a line.

  According to a sixth aspect of the present invention, there is provided a blood circuit having an arterial blood circuit and a venous blood circuit capable of extracorporeally circulating a patient's blood, and the blood connected between the arterial blood circuit and the venous blood circuit. Blood purifying means for purifying blood flowing through the circuit, a priming liquid distribution line connected to the blood circuit and capable of circulating a priming liquid, and the blood purifying means circulating blood extracorporeally in the blood circuit And a control means for supplying or discharging priming fluid to or from the blood circuit via the priming fluid distribution line before performing blood purification treatment by purifying the blood circuit. Priming in the priming fluid distribution line after the priming and before the blood purification treatment The characterized in that to replace the air.

  The invention according to claim 7 is the priming method of the blood purification apparatus according to claim 6, wherein the priming liquid circulation line is connected to an air trap chamber for gas-liquid separation formed in the blood circuit, The priming liquid circulation is configured by providing a liquid level adjusting means capable of adjusting the liquid level by supplying or discharging air to the air trap chamber, and operating the liquid level adjusting means to supply air. The priming solution in the line can be replaced with air.

  The invention according to claim 8 is the priming method of the blood purification apparatus according to claim 6, wherein the priming liquid circulation line is connected to an air trap chamber for gas-liquid separation formed in the blood circuit, By operating a pump or a solenoid valve included in the blood purification device, the priming liquid in the priming liquid circulation line can be sucked into the air trap chamber and replaced with air.

  A ninth aspect of the present invention is the priming method for a blood purification apparatus according to any one of the sixth to eighth aspects, wherein the priming liquid distribution line can discharge the priming liquid from the blood circuit during priming. It consists of an overflow line.

  A tenth aspect of the present invention is the priming method of the blood purification apparatus according to any one of the sixth to eighth aspects, wherein the priming liquid distribution line can supply a priming liquid into the blood circuit at the time of priming. It consists of a priming liquid supply line.

  According to the first and sixth aspects of the present invention, the priming liquid in the priming liquid distribution line is replaced with air after the completion of priming and before the blood purification treatment. It is possible to reliably prevent the mixed priming liquid from scattering around.

  According to the second and seventh aspects of the present invention, since the priming liquid in the priming liquid distribution line can be replaced with air by operating the liquid level adjusting means and supplying air, the liquid level adjusting means is provided in the air trap chamber. In addition to the liquid level adjustment function, it can also serve as a function of replacing the priming liquid in the priming liquid distribution line with air.

  According to the third and eighth aspects of the present invention, the priming liquid in the priming liquid distribution line can be sucked into the air trap chamber and replaced with air by operating the pump or the electromagnetic valve provided in the blood purification apparatus. The priming liquid in the priming liquid distribution line can be replaced with air without being discharged to the outside.

  According to the fourth and ninth aspects of the present invention, the priming fluid distribution line is composed of an overflow line that can discharge the priming fluid from the blood circuit at the time of priming. Can be reliably prevented from being scattered around.

  According to the fifth and tenth aspects of the present invention, the priming liquid distribution line is composed of a priming liquid supply line that can supply the priming liquid into the blood circuit at the time of priming. It is possible to reliably prevent the mixed priming liquid from scattering around.

The schematic diagram which shows the blood purification apparatus which concerns on the 1st Embodiment of this invention. Flow chart showing control contents of the blood purification apparatus The schematic diagram which shows the state in the replacement | exchange process of the priming liquid and air in the blood purification apparatus The schematic diagram which shows the state after the substitution process of the priming liquid and air in the blood purification apparatus The schematic diagram which shows the blood purification apparatus which concerns on the 2nd Embodiment of this invention. Flow chart showing control contents of the blood purification apparatus The schematic diagram which shows the state in the substitution process (formation of a negative pressure) of priming liquid and air in the blood purification apparatus The schematic diagram which shows the state in the replacement | exchange process of the priming liquid and air in the blood purification apparatus The schematic diagram which shows the state in the substitution process of the priming liquid and air in the blood purification apparatus of another form The schematic diagram which shows the blood purification apparatus which concerns on the 3rd Embodiment of this invention. Flow chart showing control contents of the blood purification apparatus The schematic diagram which shows the state in the substitution process of the priming liquid and air in the priming liquid supply line which concerns on the blood purification apparatus The schematic diagram which shows the state in the substitution process of the priming liquid and air in the overflow line which concerns on the blood purification apparatus The schematic diagram which shows the state in the substitution process of the priming liquid and air in the overflow line which concerns on the blood purification apparatus

Hereinafter, embodiments of the present invention will be specifically described with reference to the drawings.
The blood purification apparatus according to the first embodiment is used in blood purification treatment (hemodialysis treatment) that can purify the patient's blood while circulating it outside the body. As shown in FIG. A blood circuit having a circulatory arterial blood circuit 2 and a venous blood circuit 3, and a dialyzer 1 connected between the arterial blood circuit 2 and the venous blood circuit 3 to purify blood flowing through the blood circuit ( Blood purification means), a piping section including a dialysate introduction line L1 and a dialysate discharge line L2 disposed in the dialyzer main body B, and a control means 18.

  The dialyzer 1 is for purifying blood and is connected to the arterial blood circuit 2 and the venous blood circuit 3 constituting the blood circuit via the ports 1a and 1b, respectively, and via the ports 1c and 1d. The dialysate introduction line L1 and the dialysate discharge line L2 are connected to each other. The arterial blood circuit 2 is provided with a blood pump 4 composed of a squeezing type pump. By driving the blood pump 4, a liquid such as dialysate can be fed through the blood circuit. ing.

  The arterial blood circuit 2 is formed with an arterial air trap chamber 5 for gas-liquid separation, and the venous blood circuit 3 is formed with a venous air trap chamber 6 for gas-liquid separation. The arterial air trap chamber 5 and the venous air trap chamber 6 can remove bubbles in the liquid flowing in the blood circuit. It should be noted that air bubbles in the blood flowing through the arterial blood circuit 2 or the venous blood circuit 3 during blood purification treatment are present at the distal end of the arterial blood circuit 2 and the distal end of the venous blood circuit 3 according to the present embodiment. Bubble detectors (D1, D2) that can be detected are connected.

  In addition, a connector to which an artery side puncture needle and a vein side puncture needle can be attached is formed at the distal end of the arterial blood circuit 2 and the distal end of the venous blood circuit 3, respectively. Priming is performed, and after priming, the patient is collected from the arterial puncture needle by attaching the arterial puncture needle and the venous puncture needle to the connector to puncture the patient and driving the blood pump 4 The blood is circulated extracorporeally in the blood circuit, purified and drained with dialyzer 1, and then returned to the patient from the venous puncture needle.

  Further, the arterial blood circuit 2 is provided with clamping means Va on the distal end side (upstream (front end) side from the portion where the priming fluid supply line La is connected), and the venous blood circuit 3 includes a distal end. Clamping means Vb is disposed on the side (downstream (tip) side from the site where the vein-side air trap chamber 6 is formed). The arterial air trap chamber 5 is connected to a sensor that can detect the fluid pressure on the inlet side of the dialyzer 1 in the blood circuit, and the venous air trap chamber 6 detects the venous pressure in the blood circuit during treatment. Possible sensors are connected.

  Further, a dual pump 7 as a liquid feed pump for supplying a dialysate adjusted to a predetermined concentration to the dialyzer 1 and discharging the drainage from the dialyzer 1 to the dialysate introduction line L1 and the dialysate discharge line L2. Is connected. That is, a dual pump 7 is disposed across the dialysate introduction line L1 and the dialysate discharge line L2. By driving the dual pump 7, the dialysate is introduced to the dialyzer 1 at the dialysate introduction line L1. The dialysate (drainage) can be discharged through the introduction and dialysate discharge line L2.

  Further, the filters 11 and 12 are connected to the dialysate introduction line L1, and the dialysate introduced into the dialyzer 1 can be filtered by the filters 11 and 12, and at any timing by the electromagnetic valves V1, V7, and V8. The channel can be blocked or opened. The dialysate introduction line L1 is connected to the dialysate discharge line L2 through bypass lines L7, L8, and L9, and solenoid valves V3, V4, and V12 are connected to these bypass lines L7, L8, and L9, respectively. Has been. Further, a sampling port 10 (sample port) capable of collecting the dialysate flowing through the dialysate introduction line L1 is connected to the dialysate introduction line L1.

  The dialysate discharge line L2 can be blocked or opened at any timing by electromagnetic valves V2 and V9, and is connected to bypass lines L3 and L4 that bypass the duplex pump 7, and the bypass line L3 Is connected to a water removal pump 8. Note that a solenoid valve V5 is connected to the bypass line L4. Thus, the water removal pump 8 is driven in the process of circulating the patient's blood extracorporeally in the blood circuit, so that water can be removed from the blood flowing through the dialyzer 1 to remove water.

  Further, a pressure pump 9 for adjusting the fluid pressure of the dialysate discharge line L2 in the duplex pump 7 is connected to the upstream side (left side in the figure) of the duplex pump 7 in the dialysate discharge line L2. A detour line L <b> 5 extends between the pressure pump 9 and the dual pump 7 through a degassing chamber 13. The degas chamber 13 captures bubbles in the dialysate flowing through the dialysate discharge line L2 upstream of the duplex pump 7, and discharges the duplex pump 7 from the bypass line L5 to the outside. .

  An electromagnetic valve V6 is connected to the bypass line L5, and these flow paths are disposed upstream of the electromagnetic valve V6 (between the degassing chamber 13 and the electromagnetic valve V6) and the bypass line L9. Is connected to the branch line L6. The branch line L6 includes a further branch line of the detour line L5 branched from the dialysate discharge line L2, and is connected to the solenoid valve V10 and the solenoid valve V11, and is connected between the solenoid valve V10 and the solenoid valve V11. Is attached with a connection port 14 to which one end of the overflow line Lb can be connected.

  The electromagnetic valve V10 according to the present embodiment is disposed in the flow path between the connection port 14 and the water removal pump 8, and the electromagnetic valve V11 is on the opposite side of the electromagnetic valve V10 across the connection port 14. It is arranged in the flow path. Then, by connecting the tip of the overflow line Lb extending from the upper part of the venous air trap chamber 6 to the connection port 14, the priming solution supplied into the blood circuit can flow to the dialysate discharge line L2. It has become. Note that reference numeral 15 in the drawing indicates a filter 15 attached to the branch line L6, and the filter 15 can capture foreign substances contained in the liquid flowing from the blood circuit.

  In the overflow line Lb, the flow path can be opened and closed by an overflow clamp Vd (clamping means), and one end of the overflow line Lb is connected to the upper portion of the vein-side air trap chamber 6 and the other end is connected to the connection port 14. At the time of priming, by opening the overflow clamp Vd, the priming solution supplied into the blood circuit can flow into the dialysate discharge line L2, and can be discharged from there.

  The dialysis machine main body B has a dialysis fluid introduction line L1 for introducing a dialysis fluid into the dialyzer 1, a piping section including a dialysis fluid discharge line L2 for discharging the dialysis fluid from the dialyzer 1, and a control means 18. In addition to the dialysate introduction line L1 and the dialysate discharge line L2, the piping section according to the present invention includes detour lines (L3, L4, L5) branched from the dialysate introduction line L1 and the dialysate discharge line L2, and a branch line L6. And a bypass line (L7, L8, L9) etc. can be circulated and a dialysis fluid etc. can be distribute | circulated.

  On the other hand, one end of the priming solution supply line La is connected to the sampling port 10 formed in the middle of the dialysate introduction line L1. The priming liquid supply line La has a flow path that can be opened and closed by the clamping means Vc, and has one end at the sampling port 10 and the other end at the arterial blood circuit 2 (a portion between the clamping means Va and the blood pump 4). Are connected to each. At the time of priming, the clamp means Va is opened, so that the dialysate in the blood introduction line L1 can be supplied into the blood circuit as the priming liquid.

  A replacement fluid line Lc is branched and extended from the middle of the priming fluid supply line La. The replacement fluid line Lc is provided with a replacement fluid pump 16 including a peristaltic pump, and one end is connected to the priming fluid supply line La and the other end is connected to the upper part of the artery-side air trap chamber 5. Then, by driving the replacement fluid pump 16, the dialysate in the dialysate introduction line L1 can be supplied as a replacement fluid into the blood circuit. When the replacement fluid pump 16 is stopped, the flow path of the replacement fluid line Lc is closed by a roller provided in the replacement fluid pump 16.

  Furthermore, in this embodiment, the liquid level adjustment means 17 which can adjust the liquid level of the artery side air trap chamber 5 and the vein side air trap chamber 6 is provided. The liquid level adjusting means 17 includes an extending tube L10 extending from the upper part (air layer) of the venous air trap chamber 6 and an extending part extending from the upper part (air layer) of the artery side air trap chamber 5. Tube L11, connection tube L12 connected to extension tubes L10 and L11, open tube L13 having one end connected to connection tube L12 and the other end opened to the atmosphere, and liquid disposed in open tube L13 And a surface adjustment pump 17a. Note that an electromagnetic valve Ve that opens and closes the extended tube L10 side and an electromagnetic valve Vf that opens and closes the extended tube L11 side are attached to the connection tube L12.

  The liquid level adjustment pump 17a is composed of a squeezing pump that can be driven forward and backward. By squeezing the open tube L13 in the longitudinal direction, the upper side of the artery side air trap chamber 5 or the venous side air is provided. Air is introduced into or discharged from the upper portion of the trap chamber 6 as desired. Accordingly, when the liquid level adjustment pump 17a is driven to rotate forward (clockwise in the drawing), air is sucked from the tip of the open tube L13. Therefore, when the electromagnetic valve Ve is open, the extension tube L10 is When air is introduced into the venous air trap chamber 6 to lower the liquid level and the liquid level adjusting pump 17a is driven to rotate backward (counterclockwise in the figure), the tip of the open tube L13 Therefore, when the electromagnetic valve Ve is in the open state, air can be discharged from the vein-side air trap chamber 6 through the extension tube L10 to raise the liquid level.

  Similarly, when the liquid level adjusting pump 17a is driven to rotate in the forward direction, air is sucked from the tip of the open tube L13. Therefore, when the electromagnetic valve Vf is in the open state, the artery side air trap chamber 5 is passed through the extension tube L11. When the liquid level adjusting pump 17a is driven to rotate in reverse, air is discharged from the tip of the open tube L13, so that when the solenoid valve Vf is open, Air can be discharged from the artery side air trap chamber 5 through the extension tube L11 to raise the liquid level.

  The control means 18 is composed of a microcomputer or the like disposed in the dialyzer main body B, and priming before blood purification treatment by purifying the blood with the dialyzer 1 (blood purification means) while circulating the blood extracorporeally in the blood circuit. The priming liquid is supplied to the blood circuit via the liquid supply line La, and the priming liquid is discharged to the blood circuit via the overflow line Lb so that the blood circuit is primed.

  That is, after the connector at the distal end of the arterial blood circuit 2 and the connector at the distal end of the venous blood circuit 3 are connected to each other to form a closed circuit, the clamp means Vc is opened during priming under the control of the control means 18. As the dialysis fluid in the dialysis fluid introduction line L1 is supplied and filled as a priming fluid to the blood circuit, the overflow clamp Vd is opened to overflow the priming fluid in the blood circuit to the overflow line Lb and dialyze via the connection port. It is configured to discharge to the liquid discharge line L2.

  Then, by flowing the dialysate from the dialysate introduction line L1 to the dialysate discharge line L2, so-called gas purging is performed by filling the dialysate flow path in the dialyzer 1 with the dialysate. Thus, since priming is completed, the connection between the tip of the arterial blood circuit 2 and the tip of the venous blood circuit 3 is released, and a puncture needle is attached to each to puncture the patient. As a result of extracorporeal circulation, blood purification treatment by the dialyzer 1 is performed.

  Here, the control means 18 according to the present embodiment has remained in the priming liquid (in this embodiment, the overflow line Lb) in the overflow line Lb (priming liquid distribution line) after the priming is finished and before the blood purification treatment. The dialysis fluid (priming fluid) can be replaced with air. Specifically, the control unit 18 according to the present embodiment operates the liquid level adjusting unit 17 (that is, drives the liquid level adjusting pump 17a) to supply air into the venous air trap chamber 6 to overflow. The priming liquid in the line Lb can be replaced with air.

  For example, in the state where priming is completed and the blood circuit is filled with the priming liquid, as shown in FIG. 3, while the overflow clamp Vd and the electromagnetic valve Ve are in the open state and the clamp means Vb and the electromagnetic valve Vf are in the closed state, When the surface adjustment pump 17a is driven to rotate forward (clockwise in the drawing), air is introduced into the venous air trap chamber 6, so that the air causes the priming solution in the overflow line Lb to flow into the dialysate discharge line L2. As a result, the inside of the overflow line Lb is replaced with air from the priming liquid.

Hereinafter, specific control by the control means 18 according to the first embodiment will be described with reference to the flowchart of FIG.
First, in S1, it is determined whether the priming of the blood circuit and the gas purge of the dialyzer 1 have been completed. If it is determined that the priming has been completed, the process proceeds to S2 and subsequent steps. At this time, the distal end of the arterial blood circuit 2 and the distal end of the venous blood circuit 3 are connected to each other to form a closed circuit (that is, the priming state is maintained), and the blood circuit and the overflow line Lb is filled with a dialysis solution as a priming solution.

  If it is determined in S1 that the priming has been completed, the overflow clamp Vd is opened as shown in FIG. 3 (S2). At this time, as shown in the figure, the clamp means (Vb, Vc, Vf) on the blood circuit side are in the closed state and the clamp means Ve are in the open state (the clamp means Va may be in any open / closed state) The solenoid valves (V1, V2, V4 to V6, V10, V12) on the piping side are closed and the solenoid valves (V3, V7 to V9, V11) are opened. Note that the solenoid valves (V3, V7, V8) are open as described above when the dual pump 7 is driven. It may be in a state.

  Thereafter, the process proceeds to S3, where the liquid level adjusting means 17 is operated and the liquid level adjusting pump 17a is driven to rotate in the forward direction, whereby air is supplied into the venous air trap chamber 6 and the priming liquid in the overflow line Lb is dialyzed. While flowing into the liquid discharge line L2, it is replaced with air. Then, in S4, it is determined whether a specified time has elapsed from the start of driving the liquid level adjusting pump 17a, or whether a specified amount of air has been sent from the start of driving the liquid level adjusting pump 17a, and the specified time or specified amount is driven. When it is determined that the priming liquid in the overflow line Lb is completely replaced with air, the liquid level adjustment pump 17a is stopped (S5) and the overflow clamp Vd is closed as shown in FIG. (S6).

  The process after the end of the series of priming and before the blood purification treatment ends. Thereby, after the priming is completed and before the blood purification treatment, the priming liquid in the overflow line Lb (priming liquid distribution line) is replaced with air. Therefore, even if blood is circulated extracorporeally in the blood circuit during the blood purification treatment. It is possible to prevent blood from coming into contact with the priming liquid remaining in the overflow line Lb. Therefore, after blood purification treatment, it is possible to reliably prevent the priming liquid mixed with blood from overflowing from the overflow line Lb (priming liquid distribution line).

  Further, according to the present embodiment, since the priming liquid in the overflow line Lb (priming liquid distribution line) can be replaced with air by operating the liquid level adjusting means 17 to supply air, the liquid level adjusting means 17 However, in addition to the liquid level adjustment function of the venous air trap chamber 6, the priming liquid in the overflow line Lb (priming liquid distribution line) can be replaced with air. In particular, since the applied priming fluid distribution line is composed of an overflow line Lb that can discharge the priming fluid from the blood circuit during priming, the priming fluid mixed with blood from the overflow line Lb scatters around after blood purification treatment. It is possible to reliably prevent this.

Next, a blood purification apparatus according to a second embodiment of the present invention will be described.
As in the first embodiment, the blood purification apparatus according to the present embodiment is used in blood purification treatment (hemodialysis treatment) that can purify the patient's blood while circulating it outside the body, as shown in FIG. A blood circuit having an arterial blood circuit 2 and a venous blood circuit 3 capable of extracorporeally circulating the patient's blood, and blood connected between the arterial blood circuit 2 and the venous blood circuit 3 and flowing through the blood circuit The dialyzer 1 (blood purification means) for purifying the blood, the pipe part including the dialysate introduction line L1 and the dialysate discharge line L2 disposed in the dialyzer body B, and the control means 18 are provided. Yes. In addition, the same code | symbol is attached | subjected to the component similar to 1st Embodiment, and those detailed description is abbreviate | omitted.

  The overflow line Lb according to the present embodiment extends from the upper part of the vein-side air trap chamber 6 and has its tip opened and fixed at a position above the drainage means 19 (remaining liquid receiver). The liquid draining means 19 includes a liquid receiving portion 19a that opens upward, and a discharge tube 19b that allows the liquid received by the receiving portion 19a to flow out and be discharged to the outside.

  Since the tip of the overflow line Lb is opened above the receiving portion 19a, it is open to the atmosphere, so that the liquid in the vein-side air trap chamber 6 can be discharged to the receiving portion 19a and the outside air It is possible to inhale. Further, the tip of the discharge tube 19b may be any part or place where the priming solution can be discharged, and may be connected to the dialysate discharge line L2, for example. Note that the end of the overflow line Lb may be opened above a container such as a bucket, and the liquid may be discharged into the container.

  Here, the control means 18 according to the present embodiment has remained in the priming liquid (in this embodiment, the overflow line Lb) in the overflow line Lb (priming liquid distribution line) after the priming is finished and before the blood purification treatment. The dialysis fluid (priming fluid) can be replaced with air. Specifically, the control means 18 according to the present embodiment operates the pump or electromagnetic valve included in the blood purification apparatus to make the inside of the venous air trap chamber 6 a negative pressure, The priming solution can be sucked into the venous air trap chamber 6 and replaced with air.

  For example, when the priming is completed and the blood circuit is filled with the priming liquid, as shown in FIG. 7, the overflow clamp Vd and the clamp means Vb are closed (the electromagnetic valves (Ve, Vf) of the liquid level adjusting means 17). In the closed state), the water removal pump 8 is driven to make the dialysate flow path of the dialyzer 1 have a negative pressure. As a result, the blood circuit, in particular, the venous air trap chamber 6 can be set to a negative pressure via the filtration membrane (hollow fiber membrane) of the dialyzer 1, and the priming liquid in the overflow line Lb is supplied to the venous air trap chamber. Since air is introduced from the opening at the front end while flowing into the air, the inside of the overflow line Lb is replaced with air from the priming liquid.

  In this embodiment, by operating a pump or a solenoid valve included in the apparatus, the inside of the venous air trap chamber 6 is set to a negative pressure, and the priming liquid in the overflow line Lb is supplied to the venous air trap chamber 6. However, the priming liquid in the overflow line Lb is sucked into the venous air trap chamber 6 and replaced with air by operating a pump or an electromagnetic valve provided in the blood purification device. If so, it is not necessary to form a negative pressure in the venous air trap chamber 6.

Hereinafter, specific control by the control means 18 according to the second embodiment will be described with reference to the flowchart of FIG.
First, in S1, it is determined whether the priming of the blood circuit and the gas purge of the dialyzer 1 have been completed. If it is determined that the priming has been completed, the process proceeds to S2 and subsequent steps. At this time, the distal end of the arterial blood circuit 2 and the distal end of the venous blood circuit 3 are connected to each other to form a closed circuit (that is, the priming state is maintained), and the blood circuit and the overflow line Lb is filled with a dialysis solution as a priming solution.

  And if it determines with priming having been complete | finished in S1, as shown in FIG. 7, the dewatering pump 8 of a piping part will be driven by control by the control means 18, and a negative pressure will be formed (S2). At this time, as shown in the figure, the clamp means (Vb, Vc, Ve, Vf) on the blood circuit side and the overflow clamp Vd are in a closed state (the clamp means Va may be in any open / closed state), and piping The side solenoid valves (V1, V4 to V6, V12) are closed and the solenoid valves (V2, V3, V7 to V9) are opened. Note that the solenoid valves (V3, V7, V8) are open as described above when the dual pump 7 is driven. It may be in a state. Further, when pressure is generated with a height difference (head difference) by opening the solenoid valve V5 on the piping side, a negative pressure may be formed with the pressure due to the height difference.

  Furthermore, the pressurizing pump 9 may be either driven or stopped, and as shown in FIG. 9, the pressurizing pump 9 may be driven instead of the water removal pump 8 to form a negative pressure. In this case, as shown in the figure, the clamp means (Vb, Vc, Ve, Vf) and the overflow clamp Vd on the blood circuit side are closed (the clamp means Va may be open or closed), and the piping The side solenoid valves (V1, V4, V5, V12) are closed and the solenoid valves (V2, V3, V6 to V9) are opened. Note that the solenoid valves (V3, V7, V8) are open as described above when the dual pump 7 is driven. It may be in a state.

  Then, the process proceeds to S3, where a predetermined amount of flow has been reached from the start of driving of the water removal pump 8 (or pressurizing pump 9), or the specified pressure has been reached from the start of driving of the water removing pump 8 (or pressurizing pump 9). When it is determined whether or not the specified amount or the specified pressure has been reached, the water removal pump (or pressurizing pump 9) is stopped to stop the negative pressure formation (S4). After that, as shown in FIG. 8, the overflow clamp Vd is opened (S5), and it is determined whether or not a specified time has elapsed from the open state. It is estimated that all of the priming liquid has been replaced with air, and the overflow clamp Vd is closed (S7). In this embodiment, the negative pressure is formed in advance and then the overflow clamp Vd is opened. However, the negative pressure and the timing for opening the overflow clamp Vd may be simultaneously performed.

  The process after the end of the series of priming and before the blood purification treatment ends. Thereby, after the priming is completed and before the blood purification treatment, the priming liquid in the overflow line Lb (priming liquid distribution line) is replaced with air. Therefore, even if blood is circulated extracorporeally in the blood circuit during the blood purification treatment. It is possible to prevent blood from coming into contact with the priming liquid remaining in the overflow line Lb. Therefore, after blood purification treatment, it is possible to reliably prevent the priming liquid mixed with blood from overflowing from the overflow line Lb (priming liquid distribution line).

  Further, according to the present embodiment, the priming liquid in the overflow line Lb (priming liquid circulation line) is sucked into the venous air trap chamber 6 by operating the pump or electromagnetic valve included in the blood purification apparatus. Therefore, the priming liquid in the overflow line Lb (priming liquid distribution line) can be replaced with air without being discharged to the outside. In particular, since the applied priming fluid distribution line is composed of an overflow line Lb that can discharge the priming fluid from the blood circuit during priming, the priming fluid mixed with blood from the overflow line Lb scatters around after blood purification treatment. It is possible to reliably prevent this.

Next, a blood purification apparatus according to the third embodiment of the present invention will be described.
As in the first and second embodiments, the blood purification apparatus according to this embodiment is used in blood purification treatment (hemodialysis treatment) that can purify the patient's blood while circulating it outside the body, and is shown in FIG. As described above, the blood circuit having the arterial blood circuit 2 and the venous blood circuit 3 capable of extracorporeally circulating the patient's blood is connected between the arterial blood circuit 2 and the venous blood circuit 3, A dialyzer 1 (blood purification means) for purifying flowing blood, a pipe section including a dialysate introduction line L1 and a dialysate discharge line L2 disposed in the dialyzer body B, and a control means 18 are provided. Has been. In addition, the same code | symbol is attached | subjected to the component similar to 1st, 2 embodiment, and those detailed description is abbreviate | omitted.

  The priming fluid supply line Ld according to the present embodiment extends from the upper part of the artery-side air trap chamber 5, and the tip thereof is connected to the sampling port 10 in the dialysate introduction line L1. An iron-type replacement fluid pump 16 similar to that of the embodiment and the second embodiment is provided. When the replacement fluid pump 16 is driven, the dialysate in the dialysate introduction line L1 is introduced as a priming solution into the blood circuit, thereby enabling priming before blood purification treatment. In the present embodiment, both the priming liquid supply line Ld and the overflow line Lb constitute the “priming liquid distribution line” of the present invention.

  Here, the control means 18 according to the present embodiment is configured so that the priming liquid (in this embodiment) in the priming liquid supply line Ld and the overflow line Lb (priming liquid distribution line) after the completion of priming and before the blood purification treatment. The dialysis fluid as the priming fluid remaining in the priming fluid supply line Ld and the overflow line Lb) can be replaced with air. Specifically, the control means 18 according to this embodiment drives the replacement fluid pump 16 to supply air into the artery-side air trap chamber 5 to replace the priming solution in the priming solution supply line Ld with air. To get.

  For example, in the state where priming is completed and the blood circuit is filled with the priming fluid, the replacement fluid pump 16 is driven while the tip of the priming fluid supply line Ld is removed from the sampling port 10 and opened to the atmosphere as shown in FIG. As a result, the air sucked from the tip of the priming liquid supply line Ld pushes the priming liquid into the artery-side air trap chamber 5 and the inside of the overflow line Lb is replaced with air from the priming liquid.

Hereinafter, specific control by the control means 18 according to the third embodiment will be described with reference to the flowchart of FIG.
First, in S1, it is determined whether the priming of the blood circuit and the gas purge of the dialyzer 1 have been completed. If it is determined that the priming has been completed, the process proceeds to S2 and subsequent steps. At this time, the distal end of the arterial blood circuit 2 and the distal end of the venous blood circuit 3 are connected to each other to form a closed circuit (that is, the priming state is maintained), and the blood circuit and the priming liquid The supply line Ld and the overflow line Lb are filled with a dialysis solution as a priming solution.

  If it is determined in S1 that the priming is completed, as shown in FIG. 12, the tip of the priming liquid supply line Ld is removed from the sampling port 10 to open the atmosphere (S2), and the overflow clamp Vd is opened. A state is set (S3). At this time, as shown in the figure, the clamping means (Vb, Ve, Vf) on the blood circuit side are closed (the clamping means Va may be opened or closed), and the solenoid valve (V1 on the piping side) , V2, V4 to V6, V12) are closed, and the solenoid valves (V3, V7 to V9) are opened. Note that the solenoid valves (V3, V7, V8) are open as described above when the dual pump 7 is driven. It may be in a state.

  Thereafter, the process proceeds to S4, where the replacement fluid pump 16 is driven to suck air from the tip of the priming fluid supply line Ld, and the priming fluid in the priming fluid supply line Ld flows into the artery-side air trap chamber 5 while Replace. In S5, it is determined whether a specified time has elapsed from the start of driving the replacement fluid pump 16 or whether a specified amount of priming liquid has been delivered from the start of driving the replacement fluid pump 16, and it is determined that the specified time or specified amount has been driven. Then, it is estimated that the priming liquid in the priming liquid supply line Ld has been completely replaced with air, and the replacement fluid pump 16 is stopped (S6), and the overflow clamp Vd is closed (S7).

  Then, it progresses to S8, and as shown in FIG. 13, the dewatering pump 8 of a piping part is driven by control by the control means 18, and a negative pressure is formed (S8). At this time, as shown in the figure, the clamp means (Vb, Ve, Vf) on the blood circuit side and the overflow clamp Vd are closed (the clamp means Va may be opened or closed), and the piping side The solenoid valves (V1, V4 to V6, V12) are closed and the solenoid valves (V2, V3, V7 to V9) are opened. Note that the solenoid valves (V3, V7, V8) are open as described above when the dual pump 7 is driven. It may be in a state. Further, when pressure is generated with a height difference (head difference) by opening the solenoid valve V5 on the piping side, a negative pressure may be formed with the pressure due to the height difference.

  Then, the process proceeds to S9, where the dialysate in the dialysate discharge line L2 has reached a specified flow rate from the time when the electromagnetic valve V5 is opened, or has reached the specified pressure from the time when the electromagnetic valve V5 is opened. If it is determined whether or not the specified amount or the specified pressure has been reached, the electromagnetic valve V5 is closed and the negative pressure formation is stopped (S10). After that, as shown in FIG. 14, the overflow clamp Vd is opened (S11), and it is determined whether or not a specified time has elapsed from the open state (S12). It is estimated that all the priming liquid in the line Lb has been replaced with air, and the overflow clamp Vd is closed (S13).

  The process after the end of the series of priming and before the blood purification treatment ends. Thereby, after the priming is completed and before the blood purification treatment, the priming liquid in the priming liquid supply line Ld and the overflow line Lb (priming liquid distribution line) is replaced with air. Even when extracorporeally circulated, it is possible to prevent blood from coming into contact with the priming liquid remaining in the overflow line Lb. Therefore, after blood purification treatment, it is possible to reliably prevent the priming liquid mixed with blood from being scattered from the priming liquid supply line Ld and the overflow line Lb (priming liquid distribution line).

  Further, according to the present embodiment, the priming liquid in the priming liquid supply line Ld (priming liquid distribution line) can be replaced with air by driving the replacement liquid pump 16 to supply air. In addition to the liquid supply function, it can also serve as a function of replacing the priming liquid in the priming liquid supply line Ld (priming liquid distribution line) with air. In particular, the applied priming liquid distribution line includes a priming liquid supply line Ld that can supply the priming liquid into the blood circuit at the time of priming. Therefore, after blood purification treatment, the priming liquid mixed with blood from the priming liquid supply line Ld Can be reliably prevented from being scattered around.

  As mentioned above, although this embodiment was described, this invention is not limited to these, For example, the priming liquid supplied at the time of priming is not only a dialysate, but a physiological saline solution, another electrolyte solution, etc. Also good. In the first and second embodiments, the priming liquid in the overflow line Lb can be replaced with air after the completion of priming and before the blood purification treatment, but in the priming liquid supply line La The priming solution may be replaced with air.

  Furthermore, the method of replacing the priming liquid in the priming liquid distribution line with air is not limited to the above embodiment, and various forms of replacing the priming liquid and air after priming and before blood purification treatment are performed. Can be applied. The blood purification apparatus to which the present embodiment is applied may be of any form, for example, a device that introduces or discharges dialysate in a chamber instead of the dual pump 7, or a dialyzer 1. It is good also as what equipped the blood purifier of another form.

  If the blood purification apparatus and its priming method can replace the priming liquid in the priming liquid distribution line with air after the priming is completed and before the blood purification treatment, the apparatus has a different external shape or has other functions. The present invention can also be applied to those added.

1 Dialyzer (blood purification means)
2 Arterial blood circuit 3 Venous blood circuit 4 Blood pump 5 Arterial air trap chamber 6 Venous air trap chamber 7 Duplex pump 8 Dewatering pump 9 Pressurizing pump 10 Sampling port 11, 12 Filter 13 Degassing chamber 14 Connection port 15 Filter 16 Fluid replacement pump 17 Liquid level adjustment means 17a Liquid level adjustment pump 18 Control means 19 Drainage means L1 Dialysate introduction line L2 Dialysate discharge lines L3, L4, L5 Detour line L6 Branch lines L7, L8, L9 Bypass line La Priming liquid supply line Lb Overflow line (Priming liquid distribution line)
Lc Replacement fluid line Ld Priming fluid supply line (Priming fluid distribution line)
Vd overflow clamp

Claims (10)

A blood circuit having an arterial blood circuit and a venous blood circuit capable of extracorporeally circulating the patient's blood;
Blood purification means connected between the arterial blood circuit and the venous blood circuit and purifying blood flowing through the blood circuit;
A priming fluid distribution line connected to the blood circuit and capable of distributing a priming fluid;
Before performing blood purification treatment by purifying blood with the blood purification means while circulating blood extracorporeally in the blood circuit, supply or discharge priming liquid to or from the blood circuit via the priming liquid distribution line. Control means for performing priming of the blood circuit;
In the blood purification apparatus comprising
The blood purification apparatus according to claim 1, wherein the control means can replace the priming liquid in the priming liquid distribution line with air after the completion of the priming and before the blood purification treatment.   The priming liquid distribution line is connected to an air trap chamber for gas-liquid separation formed in the blood circuit, and a liquid capable of adjusting the liquid level by supplying or discharging air to the air trap chamber. The priming liquid in the priming liquid circulation line can be replaced with air by operating the liquid level adjusting means and supplying air by operating the liquid level adjusting means. The blood purification apparatus according to claim 1.   The priming fluid distribution line is connected to an air trap chamber for gas-liquid separation formed in the blood circuit, and the control means operates a pump or an electromagnetic valve provided in the blood purification device. The blood purification apparatus according to claim 1, wherein the priming liquid in the priming liquid distribution line can be sucked into the air trap chamber and replaced with air.   The blood purification apparatus according to any one of claims 1 to 3, wherein the priming liquid distribution line is an overflow line that can discharge the priming liquid from the blood circuit during priming.   The blood purification apparatus according to any one of claims 1 to 3, wherein the priming liquid distribution line is a priming liquid supply line capable of supplying a priming liquid into the blood circuit during priming. A blood circuit having an arterial blood circuit and a venous blood circuit capable of extracorporeally circulating the patient's blood;
Blood purification means connected between the arterial blood circuit and the venous blood circuit and purifying blood flowing through the blood circuit;
A priming fluid distribution line connected to the blood circuit and capable of distributing a priming fluid;
Before performing blood purification treatment by purifying blood with the blood purification means while circulating blood extracorporeally in the blood circuit, supply or discharge priming liquid to or from the blood circuit via the priming liquid distribution line. Control means for performing priming of the blood circuit;
In the priming method of the blood purification apparatus comprising
A priming method for a blood purification apparatus, wherein after the priming is completed and before the blood purification treatment, the priming liquid in the priming liquid distribution line is replaced with air.   The priming liquid distribution line is connected to an air trap chamber for gas-liquid separation formed in the blood circuit, and a liquid capable of adjusting the liquid level by supplying or discharging air to the air trap chamber. The priming liquid in the priming liquid distribution line can be replaced with air by operating the liquid level adjusting means and supplying air by operating the liquid level adjusting means. Priming method of blood purification apparatus.   The priming fluid circulation line is connected to an air trap chamber for gas-liquid separation formed in the blood circuit, and the priming fluid circulation line is operated by operating a pump or an electromagnetic valve provided in the blood purification device. The priming method for a blood purification apparatus according to claim 6, wherein the priming liquid in the blood can be sucked into the air trap chamber and replaced with air.   The priming method for a blood purification apparatus according to any one of claims 6 to 8, wherein the priming liquid circulation line is an overflow line that can discharge the priming liquid from the blood circuit during priming.   The priming of the blood purification apparatus according to any one of claims 6 to 8, wherein the priming liquid distribution line is a priming liquid supply line capable of supplying a priming liquid into the blood circuit during priming. Method.

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