JP6488048B2 - Blood purification equipment - Google Patents

Description

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

  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.

  The priming solution supply means in such a conventional dialyzer has a storage bag that stores a predetermined amount of the priming solution, and a priming solution supply line that extends from the storage bag and is connected to the blood circuit. At this time, the priming liquid is supplied to the blood circuit by its own weight (hydrostatic pressure due to a difference in elevation) of the priming liquid stored in the storage bag. At the time of priming, the priming liquid is supplied to the blood circuit by the priming liquid supply means and filled, and the priming liquid is overflowed through the overflow line and discharged to the outside.

JP 2010-273893 A

  In the above-described conventional blood purification apparatus, since the priming liquid is supplied to the blood circuit by the weight of the priming liquid stored in the storage bag, a sufficient hydrostatic pressure can be obtained if the storage bag is installed at a low position. In some cases, it is difficult to smoothly discharge the priming liquid from the overflow line. In addition, since the priming liquid is supplied to the blood circuit by its own weight, if the flow resistance of the priming liquid varies, it is difficult to grasp the flow rate of the liquid flowing from the blood circuit to the pipe portion, and the priming for the blood circuit is performed. The amount of liquid supplied cannot be managed accurately. Therefore, when the priming solution is used as a replacement fluid or a replacement fluid at the time of subsequent replacement fluid or blood return, there is a possibility that the replacement fluid or replacement fluid may be insufficient.

  Furthermore, the present applicant has a replacement liquid supply means for supplying a replacement liquid to the blood circuit after treatment, for example, and returning blood in the blood circuit to the patient. However, in this case, the dialysis fluid in the piping section becomes a resistance and smoothes out the replacement fluid in the blood circuit. It may be difficult to discharge.

  The present invention has been made in view of such circumstances, and it is an object of the present invention to provide a blood purification apparatus capable of smoothly flowing a liquid in a blood circuit to a piping portion and discharging it from a dialysate discharge line.

  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. A blood purification means for purifying blood flowing in the circuit, a dialysate introduction line for introducing dialysate into the blood purification means, a pipe section including a dialysate discharge line for discharging dialysate from the blood purification means, and the pipe section And a communication line that is connected to the blood circuit and allows the flow path of the piping section and the flow path of the blood circuit to communicate with each other, and is disposed in the piping section and can be connected to one end of the communication line. It is possible to control connection means, predetermined pump means capable of flowing the liquid in the piping part during blood purification treatment, and opening / closing of arbitrary clamping means arranged in the piping part, or driving of the arbitrary pump means. Control hand The connecting means is disposed upstream of the predetermined pump means in the piping section, and the control means drives the predetermined pump means to Blood for allowing fluid in the blood circuit to flow through the communication line via the communication line to be discharged from the dialysate discharge line, and for providing blood to be circulated extracorporeally in the blood circuit A pump, a first clamp means disposed in a flow path between the connection means and the predetermined pump means, and a flow path on the opposite side of the first clamp means across the connection means; Second control means, and the control means drives the predetermined pump means to discharge the liquid in the blood circuit from the dialysate discharge line. The second clamp means is closed while the pump means is open, and when the blood pump is driven to discharge the liquid in the blood circuit from the dialysate discharge line, the first clamp means is closed. However, the second clamping means is opened.

  According to a second aspect of the present invention, in the blood purification apparatus according to the first aspect of the present invention, the blood purification apparatus further comprises a supply means capable of supplying the liquid by its own weight.

  According to a third aspect of the present invention, in the blood purification apparatus according to the first or second aspect, the liquid is composed of a priming liquid supplied into the blood circuit, and the priming is performed by supplying the priming liquid. Then, by driving the predetermined pump means under the control of the control means, the priming liquid in the blood circuit is caused to flow to the piping portion via the communication line and discharged from the dialysate discharge line. It is characterized by obtaining.

  According to a fourth aspect of the present invention, in the blood purification apparatus according to the first or second aspect, the liquid is composed of a replacement liquid supplied into the blood circuit, and the replacement liquid is supplied to return blood. After being performed, the predetermined pump means is driven under the control of the control means, thereby allowing the replacement fluid in the blood circuit to flow to the piping section via the communication line and from the dialysate discharge line. It can be discharged.

  According to a fifth aspect of the present invention, in the blood purification apparatus according to any one of the first to fourth aspects, the connecting means is arranged in a branch line including a flow path branched from a predetermined portion of the dialysate discharge line. And a capture means capable of capturing a foreign substance contained in the liquid flowed from within the blood circuit is attached to the flow path upstream of the predetermined pump means in the branch line. To do.

  According to a sixth aspect of the present invention, in the blood purification apparatus according to the fifth aspect, the dialysate discharge line allows the foreign matter captured by the capturing means to flow through the branch line without passing through the predetermined pump means. It can be discharged from

  The invention according to claim 7 is the blood purification apparatus according to any one of claims 1 to 6, wherein the connection means includes a connection port to which one end of the communication line can be connected, and the piping section is washed. Alternatively, the connection port can be cleaned or disinfected at the time of disinfection.

  According to the first aspect of the present invention, the connecting means is disposed on the upstream side of the predetermined pump means in the piping portion, and the control means is configured to drive the predetermined pump means via the communication line. Since the liquid in the blood circuit can be caused to flow to the piping part and discharged from the dialysate discharge line, the liquid in the blood circuit can be smoothly flowed to the piping part and discharged from the dialysate discharge line.

  Furthermore, when the control means drives the predetermined pump means to discharge the liquid in the blood circuit from the dialysate discharge line, the control means closes the second clamp means while opening the first clamp means, When the liquid in the blood circuit is driven and discharged from the dialysate discharge line, the second clamp means is opened while the first clamp means is closed, so that the blood pump is driven to drain the liquid in the blood circuit. When flowing into the piping section, it can be discharged from the dialysate discharge line without going through a predetermined pump means.

  That is, when the liquid in the blood circuit is caused to flow to the piping portion by driving the predetermined pump means, the second clamp means is closed while the first clamp means is open, and liquid can be fed by the predetermined pump means. In addition, when the liquid in the blood circuit is caused to flow to the pipe portion by driving the blood pump, the second clamp means is opened while the first clamp means is closed, and the liquid is not sent through the predetermined pump means. Since the liquid is made possible, it is possible to avoid the difficulty in controlling the flow rate when the blood pump and the predetermined pump means are simultaneously driven to send the liquid.

  According to the second aspect of the present invention, since the supply means capable of supplying the liquid by its own weight to the blood circuit is provided, the liquid in the blood circuit can be smoothly supplied to the piping portion even when the liquid is supplied to the blood circuit by its own weight. It can be made to flow and discharged from the dialysate discharge line.

  According to the invention of claim 3, the liquid is composed of the priming liquid supplied into the blood circuit, and when the priming is performed by supplying the priming liquid, the predetermined pump means is driven by the control of the control means. As a result, the priming solution in the blood circuit can flow through the communication line to the piping part and be discharged from the dialysate discharge line, so that the priming solution in the blood circuit can smoothly flow to the piping part and discharge the dialysate. It can be discharged from the line, and the priming workability can be improved.

  According to the invention of claim 4, the liquid is composed of the replacement liquid supplied into the blood circuit, and after the blood is returned by supplying the replacement liquid, the predetermined pump means is controlled by the control means Since the replacement fluid in the blood circuit can be flowed to the piping part through the communication line and discharged from the dialysate discharge line, the replacement fluid in the blood circuit can be smoothly flowed to the piping part and dialyzed. It can be discharged from the liquid discharge line, and the workability at the time of discarding the blood circuit after returning blood can be improved.

  According to the invention of claim 5, the connecting means is disposed in the branch line composed of the flow path branched from the predetermined portion of the dialysate discharge line, and the flow path upstream of the predetermined pump means in the branch line. Since the trapping means capable of trapping the foreign matter contained in the liquid flowing from the blood circuit is attached, it is possible to prevent the foreign matter in the blood circuit from reaching the predetermined pump means.

  According to the sixth aspect of the present invention, the foreign matter captured by the capturing means by flowing the liquid in the branch line can be discharged from the dialysate discharge line without going through the predetermined pump means. Can be discharged, and the foreign matter can be prevented from reaching a predetermined pump means.

  According to the seventh aspect of the present invention, the connection means comprises a connection port that can be connected to one end of the communication line, and the connection port can be cleaned or disinfected at the time of cleaning or disinfection of the piping. Alternatively, the connecting means can be cleaned or sterilized in the disinfection step, and hygiene management of the connecting means can be performed easily and reliably.

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 Schematic diagram showing a state during priming (overflow process, first washing process) in the blood purification apparatus The schematic diagram which shows the state in the priming (liquid feeding process) in the blood purification apparatus The schematic diagram which shows the state in the priming (2nd washing | cleaning process) in the blood purification apparatus The flowchart which shows the control content of the blood purification apparatus which concerns on the 2nd Embodiment of this invention. The schematic diagram which shows the state in the priming (arterial side filling process) in the blood purification apparatus A graph showing the progress of pressure during priming (overflow process) in the blood purification apparatus The schematic diagram which shows the washing | cleaning process of the piping part in the blood purification apparatus which concerns on embodiment of this invention. The schematic diagram which shows the washing | cleaning process of the piping part in the blood purification apparatus which concerns on embodiment of this invention. The schematic diagram which shows the state in the drainage process in a circuit in the blood purification apparatus which concerns on the 3rd Embodiment of this invention. The schematic diagram which shows the state in the drainage process in a circuit in the blood purification apparatus which concerns on the 4th Embodiment of this invention. The schematic diagram which shows the blood purification apparatus which concerns on other embodiment (overflow process by a compound pump) of this invention. The schematic diagram which shows the blood purification apparatus which concerns on other embodiment (overflow process by a pressurization pump) of this invention. The schematic diagram which shows the blood purification apparatus which concerns on other embodiment (arrangement | positioning of a connection port is another position) of this invention.

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 16.

  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.

  An arterial puncture needle and a venous puncture needle can be attached to the distal end of the arterial blood circuit 2 and the distal end of the venous blood circuit 3, respectively. The patient's blood collected from the arterial puncture needle is circulated extracorporeally in the blood circuit, purified and dehydrated by the dialyzer 1, and then from the venous puncture needle. Return to the patient.

  Between the clamping means Va and the blood pump 4 in the arterial blood circuit 2, a storage bag b storing physiological saline (substitution liquid used for priming, blood return, etc.) is connected via a supply line Lc. In addition, by opening the clamping means Vc disposed in the middle of the supply line Lc, the physiological saline in the storage bag b is supplied to the arterial blood circuit 2 by its own weight (static pressure due to height difference). The blood circuit can be primed or returned. The supply line Lc constitutes “priming liquid supply means capable of supplying the priming liquid to the blood circuit by its own weight” at the time of priming, and “substitution liquid capable of supplying the replacement liquid to the blood circuit at the time of returning the blood. "Supplying means". The replacement liquid supplied to the blood circuit is not limited to physiological saline, and may be other priming liquid or replacement liquid.

  An air trap chamber 5 is connected to the arterial blood circuit 2, and clamping means Va is disposed on the distal end side (upstream from the site where the supply line Lc of the arterial blood circuit 2 is connected), An air trap chamber 6 is connected to the venous blood circuit 3, and clamp means Vb is disposed on the distal end side (downstream side of the portion where the air trap chamber 6 of the venous blood circuit 3 is connected). The 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 air trap chamber 6 has a sensor that can detect the venous pressure in the blood circuit during treatment. It is connected. In addition, the air trap chamber 5 according to the present embodiment is provided with an air release line Lb whose tip is open to the atmosphere from the top, and a clamp means Vd that can open and close the air release line Lb arbitrarily. Has been.

  Furthermore, an arterial bubble detector 17 is disposed between the clamp means Va and the connection line Lc in the arterial blood circuit 2, and the clamp means Vb and air in the venous blood circuit 3 are arranged. Between the trap chamber 6, a venous bubble detector 18 is disposed. These bubble detectors 17 and 18 are composed of sensors that can detect bubbles (air) in a liquid (blood or the like) flowing through the arterial blood circuit 2 or the venous blood circuit 3.

  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, the dual pump 7 is disposed across the dialysate introduction line L1 and the dialysate discharge line L2, and the dialysate is introduced into the dialyzer 1 at the dialysate introduction line L1 by driving the dual pump 7. 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 communicated between the upstream side of the electromagnetic valve V6 (between the chamber 13 and the electromagnetic valve V6) and the bypass line L9. The branch line L10 to be connected is connected. The branch line L10 includes a flow path branched from a predetermined portion of the dialysate discharge line L2 (specifically, a further branch line of the branch line L5 branched from the dialysate discharge line L2), and an electromagnetic valve V10 ( A first clamping means) and a solenoid valve V11 (second clamping means) are connected, and a connection port 14 (connecting means) capable of connecting the tip of the communication line La between the solenoid valve V10 and the solenoid valve V11. ) Is attached.

  In the present embodiment, the electromagnetic valve V10 as the first clamping means is disposed in the flow path between the connection port 14 and the water removal pump 8 (predetermined pump means), and as the second clamping means. The solenoid valve V11 is disposed in the flow path on the opposite side of the solenoid valve V10 (first clamp means) with the connection port 14 (connection means) interposed therebetween. Then, one end of the communication line La is connected to the connection port 14, and the other end is connected to the blood circuit (venous blood circuit 3) via the air trap chamber 6. And other replacement fluids) can flow to the dialysate discharge line L2.

  Note that a bypass line L6 extends from the connection portion of the bypass line L4 in the dialysate discharge line L2 and the pressurizing pump 9 to the bypass line L3, and a relief valve VLa is connected to the bypass line L6. ing. Further, a back pressure valve VLb is connected between the bypass line L3 and the bypass line L4 on the downstream side of the dual pump 7 in the dialysate discharge line L2.

  The dialyzer main body B has a dialysate introduction line L1 for introducing a dialysate into the dialyzer 1, a piping part including a dialysate discharge line L2 for discharging the dialysate from the dialyzer 1, and a control means 16. The piping portion according to the present invention includes a bypass line (L3, L4, L5, L6) branched from the dialysate introduction line L1 and the dialysate discharge line L2, in addition to the dialysate introduction line L1 and the dialysate discharge line L2. Line (L7, L8, L9), branch line L10, etc. are included, and dialysate can be circulated.

  The control means 16 is composed of a microcomputer or the like provided in the dialyzer main body B, and controls the opening / closing of an arbitrary clamp means (for example, an electromagnetic valve) provided in the piping part or the blood circuit and the driving of an arbitrary pump. Thus, blood purification treatment and operations before and after the treatment can be performed. Further, the communication line La is connected to a piping part and a blood circuit in the dialysis apparatus main body B, and includes a flow path that can communicate the flow path of these piping parts and the flow path of the blood circuit. The communication line La according to the present embodiment is provided with clamp means Ve. By opening the clamp means Ve, the arterial blood circuit 2 and the venous blood circuit 3 are connected via the air trap chamber 6. And the branch line L10 branched from the dialysate discharge line L2, and the flow path can be closed by closing the clamp means Ve.

  Here, in the present embodiment, the connection port 14 (connection means) is disposed on the upstream side of the water removal pump 8 (predetermined pump means) in the piping section, and the control means 16 is connected to the water removal pump 8. By driving the (predetermined pump means), the priming liquid (liquid) in the blood circuit can be caused to flow to the piping portion via the communication line La to be discharged from the dialysate discharge line L2. Specifically, at the time of priming by the supply line Lc (priming liquid supply means), the water removal pump 8 (predetermined pump means) is driven by the control by the control means 16, thereby allowing the blood circuit to pass through the communication line La. This physiological saline solution (priming solution) can be caused to flow through the piping section and discharged from the dialysate discharge line L2.

  Furthermore, the connection port 14 (connection means) according to the present embodiment is disposed in the branch line L10 including a flow path branched from a predetermined portion of the dialysate discharge line L2, and the water removal pump 8 in the branch line L10. A filter 15 (capturing means) capable of capturing foreign substances contained in the liquid flowed from the blood circuit is attached to the flow path upstream of the predetermined pump means. The filter 15 is composed of a filtration filter or the like that can capture foreign matters while allowing liquid to pass through. The filter 15 is attached to a flow path between the electromagnetic valve V10 serving as the first clamping means and the connection port 14 (connection means). Yes.

  Further, in the present embodiment, for example, the electromagnetic valve V11 (second clamp means) is opened while the electromagnetic valve V10 (first clamp means) is closed, so that the liquid flows through the branch line L10 and is filtered. The foreign matter captured by 15 (capturing means) can be discharged from the dialysate discharge line L2 without passing through the water removal pump 8 (predetermined pump means). Instead of the filter 15, another form of capturing means that can capture foreign matter contained in the liquid flowed from the blood circuit may be used.

Hereinafter, specific control during priming by the control means 16 according to the first embodiment will be described with reference to the flowchart of FIG.
First, as shown in FIG. 1, one end of the communication line La is connected to the air trap chamber 6 and the other end is connected to the connection port 14, and the distal ends of the arterial blood circuit 2 and the venous blood circuit 3 are connected. Connect them together to form a closed circuit. A storage bag b storing a physiological saline solution (priming solution) is connected to the tip of the supply line Lc.

  Then, as shown in FIG. 3, while maintaining the stopped state of the blood pump 4, the clamping means Vd is closed while the clamping means (Va, Vb, Vc, Ve) on the blood circuit side are opened, and The solenoid valves (V2 to V6, V11) are closed while the solenoid valves (V9, V10) of the piping section are opened, and the water removal pump 8 (predetermined pump means) is driven in this state to establish communication. A physiological saline solution (priming solution) in the blood circuit is caused to flow through the piping portion via the line La and is discharged from the dialysate discharge line L2 (overflow step S1). In addition, the solenoid valve (V1, V7, V8, V12) of the piping part may be in either an open state or a closed state.

  Thereafter, it is determined whether or not bubbles are detected by the bubble detector 18 on the vein side (S2). If it is determined that the bubbles are not detected for a predetermined time, as shown in FIG. The blood pump 4 is driven in reverse rotation (drive for feeding the liquid to the opposite side during treatment) while the clamp means Vc for Lc, the clamp means Ve for the communication line La, and the clamp means Vd for the atmosphere release line Lb are closed. (Liquid feeding step S3) When the bubble is detected by the vein-side bubble detector 18 (S4), the process returns to S1 to perform the overflow step again. Thus, by repeating S1 to S4 until no bubbles are detected by the bubble detector 18 on the venous side, the portion of the blood circuit (supply line) where the physiological saline solution (priming solution) has not been supplied in the overflow step S1. A physiological saline solution (priming solution) can also be fed to a portion of the route from Lc to the communication line La via the dialyzer 1.

  When it is determined in S4 that the bubble detection by the venous bubble detector 18 is not performed for a predetermined time, the blood pump 4 is stopped and the clamping means (Va, Vb, Vc, Ve) are opened while the clamping means Vd is closed, and the solenoid valves (V9, V10) of the piping are opened while the solenoid valves (V2-V6, V11) are closed, In this state, by driving the water removal pump 8 (predetermined pumping means), the physiological saline (priming solution) in the blood circuit is caused to flow to the piping part via the communication line La, and from the dialysate discharge line L2. It is discharged (first cleaning step S5). In addition, the solenoid valve (V1, V7, V8, V12) of the piping part may be in either an open state or a closed state.

  Thereafter, as shown in FIG. 5, the water removal pump 8 is stopped and the blood pump 4 is driven to rotate in the forward direction (drive for feeding the liquid in the same direction as during the treatment), and the clamping means on the blood circuit side ( The clamping means (Vd, Va or Vb) is closed while Vc, Ve) is open, and the solenoid valves (V9, V11) of the piping are opened and solenoid valves (V1, V2, V5, V10). Is closed (second cleaning step S6). As a result, the physiological saline solution (priming solution) from the part that could not be sent to the pipe part in the first cleaning step S5 (the part of the path from the supply line Lc to the communication line La via the dialyzer 1) is sent to the pipe part. Can be liquid. In addition, the solenoid valves (V3, V4, V6 to V8, V12) of the piping part may be in an open state or a closed state.

  Thus, a series of priming steps is completed. During the priming, the water removal pump 8 on the piping side is driven at an arbitrary timing, and the other pump means such as the compound pump 7 and the pressure pump 9 are stopped. Further, in the present embodiment, as described above, when the water removal pump 8 (predetermined pump means) is driven to discharge the liquid in the blood circuit from the dialysate discharge line L2 (for example, in the first washing step S5). ), The second clamp means (electromagnetic valve V11) is closed while the first clamp means (electromagnetic valve V10) is opened, and the blood pump 4 is driven to allow the fluid in the blood circuit to flow from the dialysate discharge line L2. When discharging (for example, in the second cleaning step S6), the first clamp means (electromagnetic valve V10) is closed, and the second clamp means (electromagnetic valve V11) is open.

Next, specific control during priming by the control means 16 according to the second embodiment of the present invention will be described with reference to the flowchart of FIG.
First, as shown in FIG. 7, the Y-shaped tube a is connected to the distal ends of the arterial blood circuit 2 and the venous blood circuit 3, and the communication line La is connected to the distal end of the Y-shaped tube a and the connection port 14. State (a state for performing priming). A storage bag b storing a physiological saline solution (priming solution) is connected to the tip of the supply line Lc.

  Then, as shown in the figure, while maintaining the stopped state of the blood pump 4, the clamp means (Vb, Vd) on the blood circuit side is opened while the clamp means (Vb, Vd) are closed, and The solenoid valves (V2 to V6, V11) are closed while the solenoid valves (V9, V10) of the piping section are opened, and the water removal pump 8 (predetermined pump means) is driven in this state to establish communication. A physiological saline solution (priming solution) in the blood circuit is caused to flow to the piping part via the line La and is discharged from the dialysate discharge line L2 (arterial filling step S1). In addition, the solenoid valve (V1, V7, V8, V12) of the piping part may be in either an open state or a closed state.

  In the filling step S1 on the artery side, it is determined whether or not the flow rate due to driving of the water removal pump 8 (predetermined pump means) has reached a predetermined amount (S2), and when it reaches the predetermined amount, as shown in FIG. The dewatering pump 8 (predetermined pump means) is stopped, the clamp means (Vb, Vc) on the blood circuit side are opened, the clamp means (Va, Vd) are closed, and the electromagnetic of the piping section is closed. The solenoid valves (V1, V2, V5, V6, V10) are closed while the valves (V9, V11) are opened, and the blood pump 4 is driven to rotate in that state via the communication line La. A physiological saline solution (priming solution) in the blood circuit is caused to flow through the piping portion and discharged from the dialysate discharge line L2 (vein side filling step S3). On the other hand, if the amount is equal to or smaller than the predetermined amount in S2, the filling process S1 on the artery side is continued after returning to S1. Thereby, the physiological saline solution (priming solution) at the site (the site on the path from the supply line Lc to the communication line La via the dialyzer 1) that could not be sent to the piping unit in the filling step S1 on the artery side is supplied to the piping unit. The liquid can be sent. In addition, the solenoid valve (V3, V4, V7, V8, V12) of the piping part may be in either an open state or a closed state.

  Then, in the venous filling step S3, it is determined whether or not the flow rate due to the driving of the blood pump 4 has reached a predetermined amount (S4). If it is less than the predetermined amount, the flow returns to S3 and the venous filling step S3 continues. In addition, when a predetermined amount is reached, a series of plating steps are completed. During the priming, other pump means such as the duplex pump 7 and the pressurizing pump 9 are stopped. Further, in the present embodiment, as described above, when the water removal pump 8 (predetermined pump means) is driven to discharge the liquid in the blood circuit from the dialysate discharge line L2 (in the filling step S1 on the artery side). ), The second clamp means (electromagnetic valve V11) is closed while the first clamp means (electromagnetic valve V10) is opened, and the blood pump 4 is driven to allow the fluid in the blood circuit to flow from the dialysate discharge line L2. When discharging (at the time of filling step S3 on the artery side), the second clamp means (electromagnetic valve V11) is opened while the first clamp means (electromagnetic valve V10) is closed.

  According to the said embodiment, while the connection port 14 (connection means) is arrange | positioned in the upstream of the predetermined | prescribed pump means (this embodiment dewatering pump 8) in a piping part, the control means 16 is By driving the dewatering pump 8, the liquid in the blood circuit can flow to the piping part via the communication line La and be discharged from the dialysate discharge line L 2, so that the inside of the blood circuit supplied from the supply line Lc The liquid (physiological saline) can be smoothly flowed to the piping portion and discharged from the dialysate discharge line L2.

  In particular, in the present embodiment, at the time of priming by the supply line Lc (priming liquid supply means), the water removal pump 8 (predetermined pump means) is driven by the control by the control means 16 so that the communication line La is connected. Since the physiological saline (priming solution) in the blood circuit can be flowed to the piping part and discharged from the dialysate discharge line L2, the priming solution in the blood circuit can be smoothly flowed to the piping part and from the dialysate discharge line L2. Thus, the priming workability can be improved.

  As described above, in the present embodiment, the supply line Lc (supply means) capable of supplying the liquid (priming liquid) with its own weight is provided in the blood circuit. In addition, the liquid in the blood circuit can be caused to flow through the piping portion and discharged from the dialysate discharge line L2. In addition, you may apply to the blood purification apparatus which supplies a liquid (priming liquid) to a blood circuit irrespective of its own weight.

  In addition, the connection port 14 (connection means) according to the present embodiment is disposed in the branch line L10 including a flow path branched from a predetermined portion of the dialysate discharge line L2, and predetermined pump means in the branch line L10. A filter 15 (capturing means) that can trap a foreign substance contained in a liquid (priming liquid such as a physiological saline) that has flowed from within the blood circuit in the flow path upstream of (the dewatering pump 8 in the present embodiment). ) Is attached, it is possible to prevent foreign matters in the blood circuit from reaching the water removal pump 8 (predetermined pump means).

  However, the liquid is caused to flow in the branch line L10, and the foreign matter captured by the filter 15 (capturing means) is discharged from the dialysate discharge line L2 without passing through the water removal pump 8 (predetermined pump means). preferable. For example, after the priming is completed, the foreign matter captured by the filter 15 (capturing means) is removed by flushing the branch line L10 by flowing dialysate in the direction from the solenoid valve V10 to the solenoid valve V11. The dialysate discharge line L2 can be discharged without going through the pump 8 (predetermined pump means). Thereby, the foreign matter captured by the filter 15 (capturing means) can be discharged, and the foreign matter can be prevented from reaching the water removal pump 8 (predetermined pump means).

  Further, the control means 16 according to the present embodiment drives the dewatering pump 8 (predetermined pump means) to discharge the liquid (physiological saline) in the blood circuit from the dialysate discharge line L2, and then the first clamp. The second clamp means (electromagnetic valve V11) is closed while the means (electromagnetic valve V10) is opened, and the blood pump 4 is driven to discharge the liquid (physiological saline) in the blood circuit from the dialysate discharge line L2. Since the second clamp means (solenoid valve V11) is opened while the first clamp means (solenoid valve V10) is closed, the blood pump 4 is driven to flow the liquid in the blood circuit to the piping section. In this case, the dialysate discharge line L2 can be discharged without going through the water removal pump 8 (predetermined pump means).

  That is, when the liquid in the blood circuit is caused to flow to the piping portion by driving the water removal pump 8 (predetermined pump means), the second clamp means (solenoid valve) is opened while the first clamp means (solenoid valve V10) is opened. V11) is in a closed state so that liquid removal by the water removal pump 8 is possible, and when the liquid in the blood circuit is caused to flow to the piping by driving the blood pump 4, the first clamping means (electromagnetic valve V10) is used. Since the second clamp means (solenoid valve V11) is opened while being closed, and liquid can be fed without going through the water removal pump 8, the blood pump 4 and the water removal pump 8 (predetermined pump means) are simultaneously operated. It is possible to avoid the difficulty in controlling the flow rate by driving and feeding the liquid.

  On the other hand, after the priming as described above, when the dialysis treatment (blood purification treatment) is completed, the communication line La is removed from the connection port 14 and discarded together with the blood circuit, and the piping portion is cleaned and disinfected. For example, at the time of cleaning or disinfecting the piping section, as shown in FIG. 9, a coupler C is connected to the distal end of the dialysate introduction line L1 and the distal end of the dialysate discharge line L2 to connect the dialysate introduction line L1 and the dialysate discharge line. Let L2 communicate.

  When the pipe cleaning or disinfection process is started, the solenoid valves (V3, V4, V10 to V12) are closed while the solenoid valves (V1, V2, V5 to V9) are opened, and dialysis is performed. The dual pump 7 and the pressure pump 9 are driven while supplying the cleaning liquid or the disinfecting liquid to the liquid introduction line L1. Thereby, when the cleaning liquid is supplied, the flow paths other than the branch line L10 are cleaned, and when the disinfecting liquid is supplied, the main flow paths other than the branch line L10 are disinfected. Become.

  Thereafter, as shown in FIG. 10, the electromagnetic valves (V10, V11) are opened while the drive of the dual pump 7 and the pressurizing pump 9 is maintained, and the electromagnetic valve V6 is closed. As a result, the cleaning liquid or the disinfecting liquid flows through the branch line L10, and the branch line L10 and the connection port 14 (connection means) are cleaned or disinfected in the flow process. 9 and 10 is repeatedly performed a predetermined number of times to clean or disinfect the piping portion.

  Thus, according to the present embodiment, the connection means includes the connection port 14 that can be connected to one end of the communication line La, and the connection port 14 can be cleaned or disinfected when the piping portion is cleaned or disinfected. The cleaning or disinfection of the connection means can be performed together in the cleaning or disinfection process of the piping part, and hygiene management of the connection means (connection port 14) can be easily and reliably performed.

Next, a blood purification apparatus according to a 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, after the replacement liquid supply means (supply line Lc) capable of supplying the replacement liquid to the blood circuit is supplied and the replacement liquid is supplied by the replacement liquid supply means to return the blood, the control means 16 By driving a predetermined pump means (water removal pump 8) under control, the replacement fluid in the blood circuit can flow to the piping portion via the communication line La and can be discharged from the dialysate discharge line L2. . In addition, the same code | symbol is attached | subjected to the component similar to 1st Embodiment, and those detailed description is abbreviate | omitted.

  More specifically, in this embodiment, after the blood purification treatment is completed by circulating the patient's blood extracorporeally in the blood circuit, the clamp means Vc is opened, so that the physiological saline in the storage bag b is opened. The liquid is supplied to the blood circuit as a replacement liquid, and the blood in the blood circuit is returned to the patient by replacing the supplied replacement liquid with the blood in the blood circuit. Then, after returning the blood, in the state where the blood circuit is filled with the replacement fluid, as shown in FIG. 11, the tips of the arterial blood circuit 2 and the venous blood circuit 3 are connected to form a closed circuit. At the same time, the communication line La is in a state where one end is connected to the connection port 14 and the other end is connected to the blood circuit.

  Thereafter, as shown in the figure, the clamping means (Va, Vb, Vc, Vd, Ve) on the blood circuit side are opened, and the solenoid valves (V9, V10) of the piping are opened while the solenoid valves are opened. (V1, V2, V5, V6, V11, V12) are closed, and in this state, the water removal pump 8 is driven while the blood pump 4 is driven to rotate backward. In addition, the solenoid valve (V3, V4, V7, V8) of the piping part may be in an open state or a closed state.

  In addition, the flow rate by the water removal pump 8 is set to be larger than the flow rate by the blood pump 4, and after the predetermined time has elapsed, the blood pump 4 is stopped and only the water removal pump 8 is driven. The physiological saline solution can be drawn into the piping section side by the water removal pump 8.

  As a result, a predetermined pump means (water removal pump 8 in the present embodiment) is driven under the control of the control means 16 to cause the replacement fluid in the blood circuit to flow to the piping portion via the communication line La. It can be discharged from the dialysate discharge line L2. Therefore, the replacement fluid in the blood circuit can be smoothly flowed to the piping portion and discharged from the dialysate discharge line L3, and the workability at the time of discarding the blood circuit after returning blood can be improved.

  Thus, in the present embodiment, the supply line Lc (supply means) capable of supplying a liquid (substitution liquid) by its own weight to the blood circuit is provided, so that the liquid can be smoothly supplied to the blood circuit by its own weight. In addition, the liquid in the blood circuit can be caused to flow through the piping portion and discharged from the dialysate discharge line L2. In addition, you may apply to the blood purification apparatus which supplies a liquid (substitution liquid) to a blood circuit irrespective of its own weight.

Next, a blood purification apparatus according to a fourth embodiment of the present invention will be described.
As in the first and second embodiments, 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, and is shown in FIG. As described above, after the replacement liquid supply means (supply line Lc) capable of supplying the replacement liquid to the blood circuit is supplied and the replacement liquid is supplied by the replacement liquid supply means to return the blood, the control means 16 By driving a predetermined pump means (water removal pump 8) under control, the replacement fluid in the blood circuit can flow to the piping portion via the communication line La and can be discharged from the dialysate discharge line L2. . In addition, the same code | symbol is attached | subjected to the component similar to 1st Embodiment, and those detailed description is abbreviate | omitted.

  More specifically, in this embodiment, after the blood purification treatment is completed by circulating the patient's blood extracorporeally in the blood circuit, the clamp means Vc is opened, so that the physiological saline in the storage bag b is opened. The liquid is supplied to the blood circuit as a replacement liquid, and the blood in the blood circuit is returned to the patient by replacing the supplied replacement liquid with the blood in the blood circuit. Then, after returning the blood, in a state where the blood circuit is filled with the replacement fluid, as shown in FIG. 12, the Y-shaped tube a is connected to the tips of the arterial blood circuit 2 and the venous blood circuit 3, The communication line La is connected to the tip of the Y tube a and the connection port 14 (a state for performing priming).

  Thereafter, as shown in the figure, the clamping means Vd is closed while the clamping means (Va, Vb, Vc, Vf) on the blood circuit side are opened, and the solenoid valves (V9, V10) in the piping section are closed. The electromagnetic valves (V1, V2, V5, V6, V11, V12) are closed while being in the open state, and in this state, the water removal pump 8 is driven while the blood pump 4 is driven in reverse rotation. In addition, the solenoid valve (V3, V4, V7, V8) of the piping part may be in an open state or a closed state.

  In addition, the flow rate by the water removal pump 8 is set to be larger than the flow rate by the blood pump 4, and after the predetermined time has elapsed, the blood pump 4 is stopped and only the water removal pump 8 is driven. This physiological saline solution can be drawn into the piping section side by the water removal pump 8.

  As a result, a predetermined pump means (a dewatering pump in the present embodiment) is driven under the control of the control means 16 so that the replacement fluid in the blood circuit flows through the communication line La to the piping portion and is dialyzed. The liquid can be discharged from the liquid discharge line L2. Therefore, the replacement fluid in the blood circuit can be smoothly flowed to the piping portion and discharged from the dialysate discharge line L3, and the workability at the time of discarding the blood circuit after returning blood can be improved.

  Thus, in the present embodiment, the supply line Lc (supply means) capable of supplying a liquid (substitution liquid) by its own weight to the blood circuit is provided, so that the liquid can be smoothly supplied to the blood circuit by its own weight. In addition, the liquid in the blood circuit can be caused to flow through the piping portion and discharged from the dialysate discharge line L2. In addition, you may apply to the blood purification apparatus which supplies a liquid (substitution liquid) to a blood circuit irrespective of its own weight.

  As mentioned above, although this embodiment was described, this invention is not limited to these, For example, not only the water removal pump 8 is used as a predetermined pump means, but the duplex pump 7 is used as a predetermined pump means. Also good. In this case, as shown in FIG. 13, the connection port 14 (connection means) is disposed on the upstream side of the duplex pump 7 (predetermined pump means) in the piping section, and the control means 16 is connected to the duplex pump 7. By driving the (predetermined pump means), the liquid in the blood circuit can be caused to flow to the piping part via the communication line La to be discharged from the dialysate discharge line L2.

  For example, as shown in the figure, a bypass line Le for bypassing the dual pump 7 is formed in the dialysate introduction line L1, and an electromagnetic valve Vg is disposed in the bypass line Le. Then, the clamping means Vd is closed while the clamping means (Va, Vb, Vc, Ve) on the blood circuit side are opened, and the electromagnetic valves (V9, V10, Vg) of the piping part are opened and electromagnetically opened. The valves (V1 to V6, V11, V12) are closed, and the dual pump 7 (predetermined pump means) is driven in this state. In addition, the solenoid valve (V7, V8) of the piping part may be either in an open state or a closed state.

  Thus, by driving the dual pump 7 as the predetermined pump means, the physiological saline (priming solution or replacement solution) in the blood circuit is caused to flow to the piping part via the communication line La, and the dialysate discharge line L2 Can be discharged from. The Y-tube may be connected to the tips of the arterial blood circuit 2 and the venous blood circuit 3, and the communication line La may be connected to the tip of the Y-tube and the connection port.

  Furthermore, the predetermined pump means is not limited to the one using the water removal pump 8 or the dual pump 7, but the pressurizing pump 9 may be the predetermined pump means. In this case, as shown in FIG. 14, the connection port 14 (connection means) is disposed on the upstream side of the pressurization pump 9 (predetermined pump means) in the piping section, and the control means 16 By driving the pump 9 (predetermined pump means), the liquid in the blood circuit can be caused to flow to the piping part via the communication line La and discharged from the dialysate discharge line L2.

  For example, as shown in the figure, the branch line L10 ′ is branched from the dialysate discharge line L2, and the branch port L10 ′ is connected to the connection port 14, the electromagnetic valve V10 as the first clamp means, and the electromagnetic as the second clamp means. A valve V11 is provided. Then, the clamping means Vd is closed while the clamping means (Va, Vb, Vc, Ve) on the blood circuit side are opened, and the electromagnetic valves (V6, V9, V10) of the piping part are opened and electromagnetically opened. The valves (V1, V2, V5, V11, V12) are closed, and the pressure pump 9 (predetermined pump means) is driven in this state. In addition, the solenoid valve (V7, V8) of the piping part may be either in an open state or a closed state.

  Thus, by driving the pressurizing pump 9 as a predetermined pump means, the physiological saline solution (priming solution or replacement solution) in the blood circuit is caused to flow to the piping portion via the communication line La, and the dialysate discharge line. It can be discharged from L2. The Y-tube may be connected to the tips of the arterial blood circuit 2 and the venous blood circuit 3, and the communication line La may be connected to the tip of the Y-tube and the connection port.

  On the other hand, in the above embodiment, the connection port 14 as the connection means, the electromagnetic valve V10 as the first clamp means, and the electromagnetic valve V11 as the second clamp means are further branched from the branch line L5. 15, the connecting port 14 as the connecting means, the electromagnetic valve V10 as the first clamping means, and the electromagnetic valve V11 as the second clamping means are connected to the branch line L5 as shown in FIG. It may be arranged.

  In addition to the dewatering pump 8, the dual pump 7 and the pressurizing pump 9, as other predetermined pump means, other pump means disposed in the pipe section (a pump capable of flowing the liquid in the pipe section during blood purification treatment). It is good. 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.

  The connecting means is disposed on the upstream side of the predetermined pump means in the piping section, and the control means drives the predetermined pump means so that the liquid in the blood circuit is supplied to the piping section via the communication line. The blood pump can be discharged from the dialysate discharge line, and is disposed in a blood circuit disposed in the blood circuit for circulating the blood extracorporeally, and a flow path between the connecting means and the predetermined pump means. The first clamping means provided and the second clamping means disposed in the flow path on the opposite side of the first clamping means across the connecting means, and the control means drives a predetermined pump means When the liquid in the blood circuit is discharged from the dialysate discharge line, the second clamp means is closed while the first clamp means is open, and the blood pump is driven to discharge the liquid in the blood circuit. As long as it is a blood purification device that closes the first clamp means while opening the second clamp means when discharging from the in, the external shape is different, or those with other functions added, etc. The present invention can be applied.

1 Dialyzer (blood purification means)
2 Arterial blood circuit 3 Venous blood circuit 4 Blood pumps 5 and 6 Air trap chamber 7 Duplex pump 8 Dewatering pump 9 Pressure pump 10 Sampling port 11 and 12 Filter 13 Degassing chamber 14 Connection port (connection means)
15 Filter (capturing means)
16 Control means 17 Bubble detector 18 (arterial side) Bubble detector 18 (venous side) Bubble detector L1 Dialysate introduction line L2 Dialysate discharge lines L3, L4, L5, L6 Bypass lines L7, L8, L9 Bypass line L10 Branch line La communication line Lb atmosphere release line Lc supply line (supply means)
Ld open air line

Claims (7)

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 pipe section including a dialysate introduction line for introducing dialysate into the blood purification means and a dialysate discharge line for discharging dialysate from the blood purification means;
A communication line connected to the piping part and the blood circuit and capable of communicating the flow path of the piping part and the flow path of the blood circuit;
A connecting means that is disposed in the piping part and is capable of connecting one end of the communication line;
A predetermined pump means capable of flowing the liquid in the pipe part during blood purification treatment;
Control means capable of controlling the opening and closing of any clamping means arranged in the piping section or the driving of any pump means;
In the blood purification apparatus comprising
The connecting means is disposed on the upstream side of the predetermined pump means in the piping portion, and the control means drives the predetermined pump means to drive the predetermined internal means into the blood circuit via the communication line. And the liquid can be discharged from the dialysate discharge line by flowing to the piping part, and
A blood pump disposed in the blood circuit for circulating blood extracorporeally;
First clamping means disposed in a flow path between the connection means and the predetermined pump means;
Second clamping means disposed in a flow path on the opposite side of the first clamping means across the connecting means;
And the control means drives the predetermined pump means to discharge the liquid in the blood circuit from the dialysate discharge line, while opening the first clamp means and opening the second clamp. When the means is closed and the blood pump is driven to discharge the liquid in the blood circuit from the dialysate discharge line, the second clamp means is opened while the first clamp means is closed. The blood purification apparatus characterized by the above-mentioned.   The blood purification apparatus according to claim 1, further comprising supply means capable of supplying the liquid by its own weight to the blood circuit.   The liquid is composed of a priming liquid supplied into the blood circuit, and when the priming is performed by supplying the priming liquid, the predetermined pump means is driven by the control by the control means, The blood purification apparatus according to claim 1 or 2, wherein the priming solution in the blood circuit can be caused to flow through the piping portion through the communication line and be discharged from the dialysate discharge line.   The liquid is composed of a replacement liquid supplied into the blood circuit, and after the blood is returned by supplying the replacement liquid, the predetermined pump means is driven under the control of the control means. The blood purification apparatus according to claim 1 or 2, wherein the replacement fluid in the blood circuit can be caused to flow through the piping portion via the communication line and be discharged from the dialysate discharge line.   The connection means is disposed in a branch line composed of a flow path branched from a predetermined portion of the dialysate discharge line, and the blood circuit is connected to the flow path upstream of the predetermined pump means in the branch line. The blood purification apparatus according to any one of claims 1 to 4, further comprising a capturing unit that can capture a foreign substance contained in the liquid that has flowed from the inside.   6. The blood purification apparatus according to claim 5, wherein a foreign substance captured by the capturing means can be discharged from the dialysate discharge line without passing through the predetermined pump means by flowing a liquid in the branch line.   The said connection means consists of a connection port which can connect one end of the said communication line, The said connection port was made to be washable or disinfectable at the time of washing | cleaning or disinfection of the said piping part. The blood purification apparatus as described in any one.

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