JP4313264B2 - Blood purification equipment - Google Patents

Description

  The present invention relates to a blood purification apparatus, and more particularly to an improved structure of a blood purification apparatus in which blood taken out from a patient's body is purified by a purifier and returned to the body again.

  In recent years, a so-called artificial kidney has been widely used as a blood purification device for purifying a patient's blood in order to treat patients with renal failure and maintain life. In such a device, a semipermeable membrane such as a hollow fiber cellulose membrane, a cuproammonium rayon membrane, or a polyacrylonitrile membrane is accommodated in the box, and blood is dialysis or filtered through the semipermeable membrane. For example, when a hemodialysis operation is performed, the patient's blood is brought into contact with the dialysate through a semipermeable membrane in a dialyzer as a purifier. As a result, urea, uric acid, water and the like accumulated in the blood of the patient are dialyzed and removed to purify the blood.

  In addition, a conventional blood purification apparatus having such a purifier such as a dialyzer generally has a blood supply channel for guiding blood from the body of a patient connected to the blood inflow side of the purifier, A blood return channel is connected to the blood outflow side, and a blood pump is provided on the blood supply channel among these channels. An arterial puncture needle and a venous puncture needle are respectively attached to the blood introduction side end of the blood supply channel and the blood delivery side end of the blood return channel, and are attached to the blood supply channel. The arterial puncture needle is punctured upstream of the shunt blood vessel in the patient's body, while the venous puncture needle attached to the blood return channel is punctured downstream of the shunt blood vessel, thereby It can be configured.

  Therefore, in the blood purification apparatus constituting such a blood circuit, the blood to be purified introduced into the blood supply channel through the arterial puncture needle is delivered into the purifier by the action of the blood pump. After purifying and purifying, the purified blood is allowed to flow out from the purifier into the blood return flow path, and further, through the venous puncture needle provided at the end of the blood return flow path, It is designed to be returned to the patient.

  By the way, after completion of the blood purification operation of the patient using such a blood purification device, it is necessary to perform a blood recovery operation to return the blood remaining inside the device such as the purifier and the flow path to the body of the patient. In recent years, however, the arterial puncture needle and the venous puncture needle are removed from the patient after completion of the blood purification operation in order to reduce the burden on the patient, increase the efficiency of the blood collection operation, and ensure safety. For example, Patent Document 1 proposes a device that performs a blood collection operation while puncturing a patient.

  That is, in the blood purification device disclosed in Patent Document 1, a pressure generating means capable of relatively increasing the pressure on the dialysate side in the dialyzer than the pressure on the blood side, and a blood supply channel And a second blocking means for switching the blood return flow path to the communicating / blocking state. After the blood purification operation is completed, the first blocking means is switched to the communicating / blocking state. And the second blocking means controls the communication / blocking state of the blood supply flow path and the blood return flow path while operating the pressure generating means so that the pressure on the dialysate side in the dialyzer is greater than the pressure on the blood side. By so doing, so-called reverse filtration can be performed in which the dialysate is transferred to the blood side through the semipermeable membrane in the dialyzer.

  In such a blood purification apparatus, at the time of blood collection operation, for example, first, the state in which the blood supply flow path is blocked and the blood return flow path is in communication with the first and second blocking means The pressure generating means is operated and reverse filtration is performed, whereby residual blood in the dialyzer and the blood return channel is replaced with dialysate and returned to the patient's body through the blood return channel. Then, the first and second shut-off means are switched, respectively, and the reverse of the operation by the pressure generating means is performed again in a state where the blood supply flow path is in a communicating state and the blood return flow path is in a shut-off state. While the filtration is performed, the blood pump on the blood supply flow path is reversely rotated, so that the residual blood in the blood supply flow path is caused to flow backward from the dialyzer side toward the blood inlet side. Return to the body It is, following Te is the recovery of the total amount of equipment inside the residual blood is adapted to be implemented.

  However, in such a conventional blood purification apparatus, the pressure generating means provided with a special structure is operated by the power supplied from a predetermined power source, so that the residual blood is recovered. Therefore, problems such as the installation cost of the pressure generating means and the running cost for operating it are necessary.

  In addition, in the conventional blood purification apparatus, first, the pressure generating means is operated to return the residual blood in the blood return flow path to the patient's body, and then the pressure generating means is temporarily stopped to first and The switching operation of the two blocking means is performed, and then the pressure generating means is operated again, whereby the residual blood in the blood supply channel is returned to the patient's body and is replaced with the residual blood inside the blood purification apparatus. In order to prevent the dialysate from entering the patient's body, it is necessary to perform procedures such as stopping the pressure generating means when the operation is completed. Therefore, for example, when performing blood purification operations for many patients at the same time, in particular, when performing such blood recovery operations after the blood purification operation is completed, it is necessary to perform such operations safely and appropriately. The problem of requiring a special device that automatically performs the process is also inherent.

  For this reason, in order to solve the problems described above, the present inventor does not provide any pressure generating means that is actuated by the power supplied from the power source, and by the action of gravity due to its own weight, A blood purification device capable of replacing the remaining blood with a small amount of electrolyte solution and inexpensive air and returning it to the patient's body was completed, and a separate application was filed (Japanese Patent Application No. 2004-115584).

  And in the blood purification apparatus clarified in such an application, the operation of simply rotating the knobs of several cocks and the operation of removing the blood pump from the blood supply flow path are performed and remain in the apparatus. Blood can now be advantageously collected. However, as a result of further studies by the present inventor, in such a blood purification apparatus, the operation of removing the blood pump from the blood supply flow path at the actual site is unexpectedly complicated. It became clear.

Japanese Patent Publication No. 5-15464

  Here, the present invention has been made in the background as described above, and the problem to be solved is to reduce the cost and burden on the patient with a simpler operation, while purifying the blood. It is an object of the present invention to provide an improved structure of a blood purification apparatus capable of returning blood remaining in the apparatus after the operation to the patient's body in a safer and more reliable manner.

The present invention has been made to solve the above-described problems. The first aspect of the present invention is a purifier for purifying blood and a purifier for the purifier. A blood supply channel for supplying blood to be supplied, pump means provided on the blood supply channel for delivering blood to the purifier, and connected to the purifier and purified by the purifier the blood purification device that includes a blood return passage for returning blood to the body, the upstream-side connecting portion positioned in the blood supply channel portion of the blood flow direction upstream from (a) said pump means It said pump means connecting the downstream side connecting portion that is located to the blood supply channel portion of the blood flow direction downstream of the bypass flow passage to be a bypass to said pump means, (b) such bypass flow path and Through the bypass channel A bypass flow path control means for allowing the liquid flow to the blocking, (c) a housing body electrolyte solution is accommodated, the blood supply flow of the blood flow direction upstream side of the upstream-side connecting portion such container and a liquid electrolyte supply flow path connecting the road site, the electrolyte solution contained in the該収condition, through electrolyte solution supply channel, the electrolyte solution supply means so as to be introduced into the blood supply passage When provided in (d) of the allowable inflow of the electrolyte solution through the electrolyte solution introduction control means for inhibiting, (e) before the winding-liquid supply flow channel from the electrolyte solution supply passage to the blood supply channel a first flow control means for allowing or may block the liquid flow in the blood flow direction upstream of the site where the electrolyte solution supply channel is connected to the electrolyte solution supply means, (f) prior to the winding-liquid supply installed in a flow path, prior to the electrolytic solution supply means A second flow control means for allowing or may block the liquid flow in between the upstream joint of the bypass flow path portion electrolyte solution supply channel is connected is provided and actuated the pump means In the state, the blood supply from the electrolyte solution supply means by the opening and closing operation of the flow path by the bypass flow path control means, the electrolyte solution introduction control means, the first flow control means and the second flow control means by an electrolyte solution to be introduced into the flow path, blood supply channel, Ru near the blood purification apparatus, wherein the purifier and the blood of the blood return flow path is to be recovered.

In such a blood purification apparatus according to the present invention, after the completion of the original blood purification operation, the liquid flow through the bypass channel is canceled by releasing the blocking state of the bypass channel by the bypass channel control means. On the other hand, the first flow control means shuts off the flow of the liquid upstream of the site (branch) where the electrolyte solution supply channel is connected in the blood supply channel, and introduces the electrolyte solution When the blocking state of the electrolyte solution supply channel by the control means is released, the electrolyte solution supply channel is communicated with the downstream side of the blood supply channel to which the electrolyte solution supply channel is connected. The electrolyte solution stored in the container is introduced through the electrolyte solution supply channel to the downstream side of the blood supply channel where the electrolyte solution supply channel is connected. As a result, if a thrombus is formed at a site where the electrolyte solution supply channel in the blood supply channel is connected during the blood purification operation of the patient, the thrombus is The electrolyte solution supply flow path in the channel is forced to flow downstream from the connected site.

In this way, after confirming that a certain amount of, for example, about 5 ml of electrolyte solution has been introduced downstream of the connection site to which the electrolyte solution supply channel is connected in the blood supply channel, In the flow control means, the liquid flow between the site of the blood supply flow path to which the electrolyte liquid supply flow path is connected and the upstream connection portion of the bypass flow path is blocked, and by the first flow control means, When the blocking state of the blood supply channel upstream of the portion to which the electrolyte solution supply channel is connected is released, the electrolyte solution stored in the container passes through the electrolyte solution supply channel and the electrolyte in the blood supply channel. The liquid supply flow path can be introduced upstream of the connected portion. As a result, blood remaining in the blood supply channel located upstream of the connection site (branch) with the electrolyte solution supply channel is purified by the electrolyte solution that flows into the blood supply channel. Contrary to the direction of blood flow when the operation is performed, the blood is pushed toward the patient's shunt blood vessel and thus returned to the patient's body.

Next, the first flow control means shuts off the liquid flow upstream of the site where the electrolyte liquid supply flow path is connected in the blood supply flow path, and the blood supply flow by the second flow control means. When the blocking state of the channel is released, the fluid can flow from the site where the electrolyte solution supply flow path is connected to the downstream side in the blood flow direction from the connection site, and downstream from the connection site of the electrolyte solution supply channel. The blood remaining in the blood supply flow channel, the bypass flow channel, the purifier, and the blood return flow channel located on the side of the blood is moved into the blood by the electrolyte solution introduced into the blood supply flow channel. The blood in the blood flow direction at the time of the purification operation is pushed toward the patient's shunt blood vessel, so that the residual blood in the blood supply flow path portion downstream from the site where the electrolyte liquid supply flow path is connected Can be put back into the patient's body . As described above, when a thrombus is pushed downstream of the blood supply channel by flowing a predetermined amount (for example, about 5 ml) of an electrolyte solution, for example, a filtration net or the like is provided inside. By providing the arterial chamber at a site downstream of the blood supply channel, it is possible to capture a thrombus in the arterial chamber. Here, in the blood supply channel and the blood return channel, the upstream side and the downstream side in the blood flow direction mean the upstream side and the downstream side in the blood flow direction when the blood purification operation as described above is performed. Is.

  In the blood collection operation, when the residual blood is returned to the patient's body, the inside of the apparatus is replaced with the electrolyte solution. Moreover, the replacement with the electrolyte is automatically stopped at the time when the flow of the electrolyte solution into the blood supply channel is completed despite the pump means being operated. An amount of blood corresponding to the amount of electrolyte introduced into the body is returned to the patient.

  In such a blood purification apparatus according to the present invention, as a second aspect thereof, the container in the electrolyte solution supply means has the blood supply flow path, the purifier, and the blood return flow in the direction of gravity. By disposing the electrolyte solution in the container so as to be supplied to the blood supply flow path, the purifier, and the blood return flow path under the action of gravity. A configuration in which recovery is performed is advantageously employed.

  In the third aspect of the blood purification apparatus according to the present invention, the container is constituted by a flexible bag body having a variable volume, and the electrolyte solution housed in the bag body flows out. The volume of the bag is reduced.

  Furthermore, in the fourth aspect of the blood purification apparatus according to the present invention, a partition means for partitioning the inside of the container in a liquid-tight manner is provided so as to be able to release the partition function, and the partition means partitioned by the partition means. Only the electrolyte solution present in the electrolyte solution supply channel communication side portion of the container is configured to be introduced into the blood supply channel through the electrolyte solution supply channel.

  In addition, in the fifth aspect of the blood purification apparatus according to the present invention, there is further provided compression means for pressing the container from the outside to increase the liquid pressure of the electrolyte solution housed in the container. Configured.

  Therefore, according to the blood purification apparatus according to the present invention, each control means constituted by a cock, a valve, a clamp, etc. is operated without performing any complicated work such as removing the pump means from the blood supply flow path. With this simple operation, blood remaining inside the device can be returned to the patient's body. Further, even when the pump means is activated during the blood recovery operation, the portion of the blood supply flow path from the upstream connection portion to which the bypass flow passage communicates with the downstream connection portion is bypassed. A fixed amount of liquid is circulated in an annular flow path formed by the channel. For this reason, even if the pump means is operating in a state where the liquid inflow into the blood supply channel is stopped, it is extremely advantageously prevented that the pressure in the channel becomes negative. As a result, the intrusion of air into the blood circuit caused by the negative pressure in the flow path is extremely effectively prevented, and thus high safety can be ensured. If the pressure in the flow path becomes negative and there is a very small gap or hole in the flow path or container in the system, air may enter the blood circuit from that part. Therefore, since the pump means has been operated conventionally, it has been necessary to pay close attention, and this has been one of the causes that require manpower.

  Moreover, in the blood purification apparatus according to the present invention as described above, the bypass means is provided so as to bypass the pump means, so that the pump means is operated without removing the pump means. The blood remaining in the blood purification apparatus can be easily returned to the patient's body.

  Moreover, in the blood purification apparatus according to the present invention, blood remaining in the apparatus can be returned to the patient's body without removing any puncture needle punctured into the patient's shunt blood vessel after the blood purification operation is completed. Therefore, it is possible to enjoy the advantage of not placing a heavy burden on the patient.

  Further, in such a blood purification apparatus, unlike the conventional apparatus, it is operated by power supplied from a predetermined power source, thereby pushing the dialysate into the apparatus under a desired pressure, There is no special pressure generating means that replaces the remaining blood with dialysate and returns it to the patient's body. For this reason, the installation cost of the pressure generating means and its running cost can be advantageously reduced.

  In addition, in the blood purification apparatus according to the present invention, the return of the residual blood inside the apparatus to the patient can be automatically stopped by stopping the introduction of the electrolyte solution into the blood supply channel. If the introduction amount is set in advance, it is not necessary to constantly monitor the progress of the blood collection operation after the blood collection operation is started, and it is complicated during the blood collection operation. There is no need to perform any operation, and no special equipment is installed for this purpose. Therefore, even when blood purification operations are performed on many patients at once, such operations can be performed safely without requiring special equipment or a lot of human resources for the blood collection operation after the blood purification operation is completed. It can be implemented reliably and reliably.

  In addition, if the amount of the electrolyte solution introduced into the blood supply channel is, for example, equal to or greater than the total volume of the blood supply channel, the purifier, and the blood return channel, this amount is required. The total amount of blood remaining inside the device will be returned to the patient's body, while it is less than the total volume of the blood supply channel volume, the purifier volume, and the blood return channel volume. If the amount is taken, it is possible to prevent the electrolyte solution from flowing into the body. In other words, depending on the patient's symptoms, for example, to return as much blood as possible to an anemic patient, and to avoid putting extra water into the body as much as possible to a patient with a bad heart. The blood collection operation can be carried out.

  Therefore, by using the blood purification apparatus according to the present invention as described above, a safe and reliable blood collection operation can be carried out more easily while keeping the cost and burden on the patient low. .

  According to the second aspect of the blood purification apparatus according to the present invention, the container in which the electrolyte solution is accommodated is higher than the blood supply channel, the purifier, and the blood return channel, and the patient The blood collection operation is performed under the state where the water column pressure corresponding to the internal pressure of the shunt blood vessel is arranged at a position higher than the position corresponding to the internal pressure higher than the shunt blood vessel. Thus, the electrolyte solution is advantageously and surely introduced into the blood supply channel through the electrolyte solution supply channel by the action of gravity due to its own weight. Even more efficiently, it will be returned to the patient's body.

  Further, according to the third aspect of the blood purification apparatus according to the present invention, the electrolyte solution accommodated in the container can be stably introduced into the blood supply channel when the blood collection operation is performed, The blood recovery operation can be performed more reliably, and air can be effectively prevented from being mixed into the blood supply channel.

  Furthermore, according to the fourth aspect of the blood purification apparatus according to the present invention, the interior of the container is liquid-tightly partitioned by partition means provided so that the partition function can be released. It is possible to partition the electrolyte solution contained in the desired amount. Further, since the container is partitioned in a liquid-tight manner, only a desired amount of the divided electrolyte solution can be introduced into the blood supply channel through the electrolyte solution supply channel. Thereby, it is possible to prevent the electrolyte solution from being excessively introduced into the patient's body. Further, as described above, the blood collection operation according to the patient's symptoms can be advantageously performed.

  In addition, according to the fifth aspect of the blood purification apparatus according to the present invention, the internal pressure of the electrolyte solution inside the container is reduced by causing the container of the electrolyte solution supply means to be compressed by the compression means. Advantageously increased. As a result, the flow rate of the electrolyte solution into the blood supply channel is effectively increased during the blood collection operation, so that the blood collection operation can be performed more smoothly and quickly.

  Hereinafter, in order to clarify the present invention more specifically, embodiments of the present invention will be described in detail with reference to the drawings.

  First, FIG. 1 schematically shows a system diagram showing an embodiment of a blood purification apparatus according to the present invention. In FIG. 1, reference numeral 10 denotes a dialyzer (hemodialyzer), which is a kind of blood purifier, having a structure similar to that of the prior art, and a hollow fiber-shaped semi-permeable member inside a cylindrical box. A membrane is housed and configured. A blood supply channel 12 for guiding blood from the patient's body is connected to one end side of the dialyzer 10 in the axial direction, and the blood purified in the dialyzer 10 is connected to the other end side. A blood return flow path 14 for returning to the patient's body is connected. The blood supply flow path 12 and the blood return flow path 14 are configured by tubes made of a flexible material such as a resin, as in the conventional case.

  In the blood supply flow path 12, a known arterial puncture needle 16 is attached to the end opposite to the connection side of the dialyzer 10, while in the blood return flow path 14, A known vein side puncture needle 18 is attached to the end opposite to the connection side.

  Further, a blood pump 20 as a pump means having a known roller pump structure is provided on the blood supply channel 12, and is introduced into the blood supply channel 12 by the operation of the blood pump 20. After the blood is delivered into the dialyzer 10 and circulated through the dialyzer 10, it is allowed to flow out from the dialyzer 10 into the blood return channel 14.

  Thus, in the blood purification apparatus of this embodiment, the arterial puncture needle 16 attached to the end of the blood supply channel 12 is punctured on the upstream side (arterial side) of the patient's shunt blood vessel 22 in the blood flow direction. The venous puncture needle 18 attached to the end of the blood return flow path 14 is punctured on the downstream side (venous side) of the patient's shunt blood vessel 22 in the blood flow direction. The blood of the patient is circulated extracorporeally in the blood return channel 14 from the blood introduction side end of the blood supply channel 12 toward the blood delivery side of the blood return channel 14. Thus, in the present embodiment, the blood supply channel 12, the dialyzer 10, and the blood return channel 14 constitute a blood circuit.

  On the other hand, the dialyzer 10 is connected with a dialysate supply channel 24 for introducing fresh dialysate from its reservoir (not shown) into the dialyzer 10, and in the dialyzer 10, the blood supply flow The blood supplied into the dialyzer 10 through the passage 12 is brought into contact with the semipermeable membrane through the dialysis and filtration action of the semipermeable membrane to remove unnecessary or harmful substances and moisture from the blood. A dialysate discharge channel 26 is connected to discharge the dialysate that has come to be contained. In FIG. 1, 28 and 30 are an arterial chamber and a venous chamber respectively provided on the blood supply channel 12 and the blood return channel 14, and when the blood purification operation is performed, The blood in the blood supply flow path 12 and the blood return flow path 14 is temporarily stored in each chamber, and air mixed in the blood is removed, and a filtration net or the like disposed in the chamber is used. Blood in each chamber is filtered, and blood clots in the blood are captured and removed, so that the blood purification operation can be performed safely.

  And in such a blood purification apparatus of this embodiment, in the collection | recovery operation | movement of the residual blood inside the apparatus implemented after completion | finish of the blood purification operation mentioned later, especially electrolyte solution (here physiological saline) ) To the inside of the device.

  That is, in the blood supply flow path 12 of the blood purification apparatus, the blood flow direction of the blood pump 20 (see FIG. 2) is bypassed with respect to the blood supply flow path 12 in which the blood pump 20 is disposed. In FIG. 1, the direction B), a bypass channel 34 that connects the upstream site and the downstream site is formed in communication with the blood supply channel 12. That is, the blood supply flow path 12 is branched into the main flow path 32 and the bypass flow path 34 at the upstream connection portion 36 located at a position upstream of the site where the blood pump 20 is disposed. The flow path 32 and the bypass flow path 34 are joined at a downstream connection portion 38 located downstream of the site where the blood pump 20 is disposed and upstream of the site where the arterial chamber 28 is disposed. ,It is configured.

  A first cock 40 as a bypass flow path control unit is attached on the bypass flow path 34. The first cock 40 has a known structure, and the bypass passage 34 is closed by rotating the knob 42 to block or prevent the liquid flow through the bypass passage 34. The state in which the flow path 34 and the blood supply flow path 12 are not communicated with each other, the bypass flow path 34 is opened, and the liquid flow through the bypass flow path 34 is allowed. The state in which the communication is made can be switched alternatively.

  In addition, in the blood supply channel 12, an electrolyte solution supply channel 44 that branches and extends from the site further upstream than the above-described upstream connection portion 36 is provided in the blood supply channel. 12 is formed in a state where it is in communication with 12. A storage bag 46 serving as a storage body connected to the electrolyte solution supply channel 44 is attached to the end of the electrolyte solution supply channel 44 opposite to the blood supply channel 12 side. .

  The storage bag 46 has a flexibility that can be easily crushed and deformed from the inflated state, and is constituted by a bag body whose volume is variable between the inflated state and the crushed state. The accommodation bag 46 contains physiological saline as an electrolyte solution, and the opposing wall surfaces of the accommodation bag 46 approach each other as the physiological saline flows into the electrolyte solution supply channel 44. By doing so, the storage bag 46 is crushed and its volume is reduced. In the present embodiment, the volume when the storage bag 46 is inflated is the total volume of the volume of the blood supply channel 12, the volume of the dialyzer 10, and the volume of the blood return channel 14 (inside the apparatus). The volume is approximately the same as or larger than (volume), and the inside is filled with physiological saline.

  In the present embodiment, the storage bag 46 in which physiological saline is stored is attached at a position higher than the blood supply channel 12, the dialyzer 10, and the blood return channel 14. In this case, the accommodation bag 46 is positioned higher than the position of the shunt blood vessel 22 by the height of the water column pressure corresponding to the internal pressure of the patient's shunt blood vessel 22 (internal pressure corresponding height). It is arranged so as to be located higher than (). Thereby, without using any special device such as a pump, the physiological saline stored in the storage bag 46 is passed through the electrolyte solution supply channel 44 or the like by the action of gravity due to its own weight, and in the device or the patient. It can be introduced into the body.

  The accommodation bag 46 shown in FIG. 1 is provided with a mounting hole 47 at an upper portion thereof. The mounting hole 47 is supported by being locked to a stand or the like (not shown). 46 can be easily placed at a desired height.

  Furthermore, the storage bag 46 shown in FIG. 1 is provided with a partition device 60 as a partition means capable of partitioning the inside of the storage bag in a liquid-tight manner. It is divided into two liquid-tight. Of the two halves, a desired specific amount of physiological saline is provided inside the communication port 45 with the electrolyte solution supply channel 44, that is, below the attachment site of the partition device 60. Is housed.

  More specifically, as shown in FIGS. 1 and 2, the partition device 60 described above includes a pair of partition plates 62 and 64 which are made of a substantially rectangular flat plate having a small width and are arranged to face each other. Configured. Each of the pair of partition plates 62 and 64 has a length longer than the width of the storage bag 46, and is pivotally supported integrally at one end (right end in the figure). It is possible to relatively rotate about the shaft portion of the end portion. In addition, at the other end of the partition plate 62 located on the lower side in FIG. 2, a flexible claw portion 66 capable of bending deformation is formed so as to protrude to the partition plate 64 side. By engaging the claw portion 66 so as to cover the end face of the partition plate 64, the pair of partition plates 62 and 64 can be integrated so as not to be relatively movable. In addition, due to such engagement, the opposed inner side surfaces 68 and 70 of the pair of partition plates 62 and 64 are pressed against each other.

  Then, with the partition plates 62 and 64 of the partition device 60 disengaged, the storage bag 46 is placed between the inner side surfaces 68 and 70 of the pair of partition plates 62 and 64 as shown in FIG. After the arrangement, when the partition device 60 is engaged, the storage bag 46 is firmly sandwiched between the partition plates 62 and 64, and the interior of the storage bag 46 can be partitioned into two in the vertical direction. At this time, if the volume on the side of the communication port 45 of the storage bag 46 partitioned by the partition device 60 is an intended amount, only the partitioned specific amount of physiological saline passes through the electrolyte solution supply channel 44. The physiological saline stored on the upper side of the partition device 60 is allowed to flow out of the storage bag 46 from the storage bag 46. However, it remains in the storage bag 46 as it is. Thereby, an excessive outflow of physiological saline can be advantageously prevented by a simple operation.

  In addition, in addition to the partition device 60 as described above, the storage bag 46 according to this embodiment has an internal pressure of physiological saline stored in the storage bag 46 as shown in FIG. A compression device 72 is provided as a compression means. As shown in FIG. 3, the compression device 72 is formed of a substantially rectangular flat plate, and has two compression plates 74 and 74 disposed to face each other. An arm portion 76 having a V shape in the thickness direction is integrally provided at one end portion in the length direction of each compression plate 74, and the V shape of the arm portion 76 is provided. In the top portion, a cylindrical connecting portion 78 extending in the width direction and holes (not shown) of a size that allows the cylindrical connecting portion 78 to be inserted are alternately positioned in the width direction. A plurality are provided. Then, in a state where the two compression plates 74 and 74 having such a structure are opposed to each other, each cylindrical connecting portion 78 of the arm portion 76 of one of the two compression plates 74 and 74 is By inserting the rotary shafts 80 into the respective inner holes of the respective cylindrical connecting portions 78 by being fitted into the respective holes of the arm portion 76 of the other one of them, The two compression plates 74 and 74 are coupled around the rotation shaft 80 so as to be rotatable in directions approaching / separating from each other. Further, in the compression device 72 in which the two compression plates 74 and 74 are connected, the ends of the arm portions 76 opposite to the compression plate 74 are separated from each other between the opposing surfaces of the arm portions 76 and 76. A torsion coil spring 82 is disposed that exerts an urging force in a direction in which the compression plates 74 are brought closer to each other.

  As a result, in the compression device 72, the end portions on the opposite side of the compression plate 74 of each arm portion 76 are pressed in a direction in which the two compression plates 74 and 74 are separated from each other. In this state, the storage bag 46 (here, the portion on the side of the communication port 45 partitioned by the partition device 60) is positioned between the two compression plates 74, 74, and each arm portion Since the pressing force against 76 is released, the accommodation bag 46 can be pressed based on the urging force of the torsion coil spring 82. Then, the pressure of the compression device 72 can appropriately increase the pressure of the physiological saline stored below the partition device 60, and hence the physiological saline in the electrolyte solution supply channel 44. The pressing speed of the compression device 72 can effectively increase the flow rate of physiological saline to the blood supply channel 12.

  On the other hand, a second cock 48 as an electrolyte solution introduction control means is attached on the electrolyte solution supply channel 44. The second cock 48 also has a known structure, similar to the first cock 40 described above, and the electrolyte solution supply flow path 44 is closed by the turning operation of the knob 50, so that the electrolyte solution supply flow is closed. The state in which the channel 44 and the blood supply channel 12 are not communicated with each other, and the state in which the electrolyte solution supply channel 44 is opened and the electrolyte solution supply channel 44 and the blood supply channel 12 are communicated are selected. It can be switched automatically.

  Thus, when the knob 50 of the second cock 48 is rotated so as to be in a non-communication state (closed state), the physiological saline can be prevented from flowing into the blood supply channel 12. On the other hand, when the knob 50 of the second cock 48 is rotated so as to be in a communication state (open state), physiological saline is introduced into the blood supply channel 12 through the electrolyte solution supply channel 44. To get. Therefore, in the present embodiment, the electrolyte solution supply means is configured by the electrolyte solution supply channel 44 and the storage bag 46.

  Further, in the blood supply channel 12, a part upstream of the part (branch part 49) to which the electrolyte solution supply channel 44 is connected, and the upstream connection part of the branch part 49 and the bypass channel 34. A third cock 52 and a fourth cock 54 as first and second flow control means are attached to the portions between the first cock 36 and the second cock 54, respectively. The third cock 52 and the fourth cock 54 also have a known structure, similar to the first cock 40 and the second cock 48 described above, and by rotating the knobs 56 and 58, The communication state and the non-communication state in the blood supply channel 12 are configured to be selectively switched.

  By the way, in order to perform the blood purification operation using the blood purification apparatus of this embodiment having such a structure, for example, first, the whole inside of the apparatus is filled with physiological saline. Specifically, physiological saline is filled in each of the blood supply channel 12, dialyzer 10, blood return channel 14, bypass channel 30, and electrolyte solution supply channel 44. In this filling, physiological saline prepared separately is used, but in the present embodiment, physiological saline contained in the accommodation bag 46 can also be used. However, when the physiological saline in the storage bag 46 is used, the storage bag 46 is replenished with the physiological saline for the used amount, or the physiological saline corresponding to the amount used is used. It is necessary to store in advance in the storage bag 46 in advance.

  First, each of the knobs 42 of the first cock 40 and the second cock 48 disposed on the flow path (bypass flow path 34, electrolyte solution supply flow path 44) branched from the blood supply flow path 12; 50 are respectively rotated to the closed position so that the liquid flow from the blood supply flow path 12 through the bypass flow path 34 and the outflow of physiological saline from the storage bag 46 into the blood supply flow path 12 are In any case, it is impossible. On the other hand, the knobs 56 and 58 of the third cock 52 and the fourth cock 54 disposed on the blood supply channel 12 are respectively rotated to the open position, and the main channels (12) other than the branch channel. Only the liquid is allowed to flow.

  Thereafter, as shown in FIG. 1, the arterial puncture needle 16 attached to the end of the blood supply channel 12 is punctured upstream of the patient's shunt blood vessel 22 in the blood flow direction, while the blood return channel 14. When the venous puncture needle 18 attached to the end of the puncture device is punctured downstream of the patient's shunt blood vessel 22 in the blood flow direction, both the puncture needles 16 and 18, the blood supply channel 12, the dialyzer 10, and blood The return flow path 14 constitutes a blood circuit through which the patient's blood is circulated extracorporeally.

  Next, when the blood pump 20 is activated, the blood to be purified of the patient introduced into the blood supply channel 12 through the arterial puncture needle 16 is sent into the dialyzer 10 from the blood supply channel 12. In the dialyzer 10, it is purified by being brought into contact with the dialysate through a semipermeable membrane, and this purified blood is returned to the patient from the venous puncture needle 18 via the blood return channel 14. Thus, the blood purification operation of the patient is performed.

  When the blood purification operation as described above is completed, a residual blood recovery operation for returning the blood remaining in the apparatus to the patient is performed. In this blood recovery operation, the arterial puncture needle 16 and The venous puncture needle 18 is not removed from the patient's shunt blood vessel 22 and the blood pump 20 is not removed from the blood supply flow path 12 while the blood circuit is configured. The work will proceed according to the following procedure.

  That is, when the blood purification operation is completed, the knob 42 of the first cock 40 on the bypass channel 34 is first rotated to the open position while the blood pump 20 is still operated. As a result, liquid flow through the bypass flow path 34 is allowed, and the main flow path 32 of the blood supply flow path 12 (here, from the upstream connection portion 36 to the downstream connection portion 38) and the bypass flow channel 34. A predetermined amount of liquid corresponding to the amount of operation of the blood pump 20 is repeatedly circulated counterclockwise (in the direction B in FIG. 1) in the annular flow path formed in this manner. In other words, the operation of the blood pump 20 prevents the liquid upstream of the upstream connection portion 36 from being sent to the downstream side of the downstream connection portion 38. Therefore, even if there is no inflow of liquid into the blood supply flow path 12, it is extremely advantageously prevented that the pressure in the flow path becomes negative due to the operation of the blood pump 20. As a result, the intrusion of air into the blood circuit caused by the negative pressure in the flow path is extremely effectively prevented, and thus high safety is ensured.

Next, the knob 56 of the third cock 52 on the blood supply channel 12 is rotated to the closed position. This reliably prevents the blood in the patient's body from being further taken into the blood supply channel 12 from the side of the arterial puncture needle 16.

  Following this operation, the knob 50 of the second cock 48 provided on the electrolyte solution supply channel 44 is rotated to the open position. As a result, the portion of the blood supply flow path 12 downstream of the branching portion 49 between the blood supply flow path 12 and the electrolyte solution supply flow path 44 and the electrolyte solution supply flow path 44 are communicated with each other. The physiological saline contained in the inside and the containing bag 46 is blood downstream of the branching portion 49 through the electrolyte solution supply channel 44 by the action of gravity due to its own weight and the pressing action of the compression device 72. It is introduced into the supply channel 12. Thereby, during blood purification operation, a thrombus that is often formed in the branch portion 49 of the blood supply channel 12 can be pushed away in the blood supply channel 12 from the branch portion 49 toward the downstream side in the blood flow direction. It becomes like this. That is, during blood purification operation, blood clots that are often formed in the branching portion 49 of the blood supply channel 12 are directed toward the arterial chamber 28 provided with a filtration network or the like for capturing the thrombus. The inside will be swept away.

  In this way, a certain amount (for example, about 5 ml) of physiological saline contained in the electrolyte solution supply channel 44 or in the storage bag 46 passes through the electrolyte solution supply channel 44 from the branch portion 49. After being introduced into the blood supply flow path 12 on the downstream side, the knob 58 of the fourth cock 54 on the blood supply flow path 12 is rotated to the closed position, and on the blood supply flow path 12. The knob 56 of the third cock 52 is rotated to the open position. As a result, the portion upstream of the branching portion 49 of the blood supply channel 12 and the electrolyte solution supply channel 44 communicate with each other, and physiological saline stored in the electrolyte solution supply channel 44 or the storage bag 46. However, it is introduced into the blood supply flow path 12 upstream of the branch portion 49 through the electrolyte solution supply flow path 44 by the action of gravity due to its own weight and the pressing action by the compression device 72. As a result, the blood remaining inside the upstream portion of the blood supply channel 12 is pressed by the introduced physiological saline and circulated toward the artery side puncture needle 16 side. Thus, the blood remaining in the blood supply channel 12 upstream of the branching portion 49 is replaced with physiological saline introduced from the electrolyte solution supply channel 44 or the storage bag 46, and the replacement The amount of residual blood corresponding to the amount is returned to the patient's body through the arterial puncture needle 16.

In this way, blood in the blood supply channel 12 upstream of the branching portion 49 is replaced with physiological saline, and an amount of residual blood corresponding to the replacement amount passes through the arterial puncture needle 16. After being returned to the patient's body, the knob 56 of the third cock 52 on the blood supply channel 12 is rotated again to the closed position, and the fourth cock 54 on the blood supply channel 12 is rotated. The knob 58 is again rotated to the open position. Thereby, the communication between the portion upstream of the branching portion 49 in the blood supply channel 12 and the electrolyte solution supply channel 44 is blocked, and the portion downstream of the branching portion 49 in the blood supply channel 12 The physiological saline that is communicated with the electrolyte solution supply channel 44 and is accommodated in the electrolyte solution supply channel 44 or the accommodation bag 46 is caused by the gravity action due to its own weight and the pressing action by the compression device 72. It is introduced into the blood supply channel 12 on the downstream side of the branch portion 49 through the electrolyte solution supply channel 44. The introduction of the physiological saline is performed until all of the remaining amount of the physiological saline on the side of the communication port 45 divided by the partition device 60 flows out of the storage bag 46.

  As a result, the blood remaining in the blood supply channel 12 (excluding the main channel 32), the bypass channel 34, the dialyzer 10, and the blood return channel 14 on the downstream side of the branching portion 49 is introduced into the physiology. Pressed by the physiological saline and circulated toward the venous puncture needle 18 side, and therefore, the blood supply channel 12, the bypass channel 34, the dialyzer 10, and the blood return channel 14 on the downstream side of the branch portion 49. The blood remaining inside is replaced with physiological saline, and an amount of residual blood corresponding to the amount of replacement is returned to the patient's body through the venous puncture needle 18. However, the blood remaining in the main channel 32 is circulated toward the downstream connection portion 38 in the blood supply channel 12 by the operation of the blood pump 20, and thus remains in the main channel 32. The blood to be replaced is also replaced with physiological saline introduced from the electrolyte solution supply channel 44 or the storage bag 46.

  In addition, the volume of the physiological saline on the side of the communication port 45 in the accommodation bag 46 is determined by the partition device 60 as described above, the volume of the upstream portion of the blood supply channel 12 from the branching portion 49, and the blood supply channel 12. The sum of the volume of the downstream portion of the branching portion 49, the volume of the dialyzer 10, and the volume of the blood return channel 14, that is, the residual in the blood supply channel 12, the dialyzer 10, and the blood return channel 14 Only a specific amount of physiological saline that is set according to the amount of blood and partitioned by such a partitioning device 60 is contained in the electrolyte solution supply channel 44, the blood supply channel 12, and the dialyzer. 10 is introduced into the blood return channel 14. Then, when a predetermined amount of physiological saline flows out of the storage bag 46, the flow of the liquid is automatically stopped, so that the return of residual blood to the patient's body is also automatically stopped. Will be.

  As described above, in the present embodiment, the blood collection operation according to the patient can be performed by a simple operation of simply partitioning the containing bag 46 with the partition device 60. For example, Blood recovery operations can be performed so that more blood is returned to patients with anemia, and extra water is not added as much as possible to patients with a poor heart. It is.

  As a result, first, the blood that remains in the upstream portion of the blood supply channel 12 with respect to the electrolyte solution supply channel 44 from the branching portion 49 is pushed by the physiological saline introduced to the artery. The blood that is allowed to flow in the direction of the side puncture needle 16 and remains in the upstream portion of the blood supply channel 12 with respect to the electrolyte solution supply channel 44 with respect to the branching portion 49 is thus supplied to the electrolyte solution supply channel 44. The internal blood or the physiological saline introduced from the storage bag 46 is replaced, and the remaining blood corresponding to the replacement amount is returned to the patient's body through the arterial puncture needle 16. Subsequent to this, the physiological saline that is introduced pushes the blood remaining inside the downstream portion of the blood supply channel 12 with respect to the electrolyte solution supply channel 44 with respect to the electrolyte solution supply channel 44. Further, the blood in the blood supply channel 12 is circulated toward the vein side puncture needle 18 side, so that the blood in the portion downstream from the branching portion 49 in the blood supply channel 12 is introduced from the electrolyte solution supply channel 44 or the storage bag 46. The amount of residual blood corresponding to the amount of replacement is returned to the patient's body through the venous puncture needle 18.

  As described above, in the blood purification apparatus of the present embodiment, the storage bag 46 containing physiological saline is disposed at a predetermined height before the start of the blood purification operation or after the end of the operation, and After the blood purification operation is completed, the first to fourth cocks are used without removing the arterial and venous puncture needles 16 and 18 from the patient and without performing troublesome and troublesome blood pump 20 removal work. By performing an extremely simple and simple operation that only opens and closes the flow path, a recovery operation of blood remaining in the apparatus is realized.

  Moreover, if only the desired amount of physiological saline can be discharged by partitioning the storage bag 46 with the partition device 60, the blood recovery operation can be automatically stopped, and the blood purification operation is performed. Thus, excessive administration of physiological saline into the patient's body from which water has been removed can be effectively prevented. Further, since the partition device 60 can partition a desired amount of physiological saline in a liquid-tight manner, it is advantageous to use a general-purpose physiological saline bag that is commercially available in a predetermined amount such as 200 ml and 500 ml. The advantage that it can be used is enjoyed.

  Therefore, when such a blood purification apparatus is used, for example, even when blood purification of many patients is performed at once, after the blood purification operation is completed, the blood collection operation of each patient is performed by many humans. It can be carried out safely and appropriately without taking a lot of time and effort, putting a heavy burden on the patient, and without using a special device.

  In addition, in the blood purification apparatus of this embodiment, residual blood inside the apparatus is replaced with physiological saline introduced into the blood supply channel 12 or the blood return channel 14 by the action of gravity. Thus, since the blood is returned to the patient's body, the cost required for the recovery operation of the residual blood can be extremely advantageously reduced.

  In the present embodiment, when the blood collection operation is performed, the storage bag 46 is compressed by the compression device 72, and the internal pressure of the physiological saline in the storage bag 46 is appropriately increased. In addition to the action of gravity described above, a pressurizing action by the compression device 72 is also added, so that the inflow rate of physiological saline into the blood supply channel 12 is effectively increased, so that the blood recovery operation can be performed. It can be implemented more smoothly and quickly.

  The exemplary embodiments of the present invention have been described in detail above. However, the embodiments are merely examples, and the present invention is limited in any way by specific descriptions according to such embodiments. It should be understood that it is not interpreted.

  For example, in the above-described embodiment, the storage bag 46 is partitioned by the partition device 60 as partition means. For example, when the storage bag 46 in which a desired amount of physiological saline is stored in advance is used. In such a case, it is not necessary to use the partition device 60.

  In the above example, the compression device 72 as the compression means is attached to the storage bag 46, whereby the internal pressure in the storage bag 46 is increased and the blood collection operation is performed quickly. Without attaching 72, it is possible to sufficiently perform the blood collection operation as described above only by the dead weight of physiological saline.

  Furthermore, it goes without saying that the structures of the partitioning means and the pressing means are not limited to those shown in the embodiment. For example, instead of the compression device 72 that mechanically compresses, a structure in which the storage bag 46 is pressed from the outside by using fluid pressure may be employed.

  In the above example, the knob is rotated as a bypass flow path control means, an electrolyte solution introduction control means, a first flow control means, and a second flow control means that allow or prevent liquid flow in the flow path. The cock that opens and closes the flow path by adopting it was adopted, but instead of such a cock, it is possible to change to various members having a known opening and closing mechanism such as a clamp member and a valve member, for example It is. Furthermore, it is also possible to use a detachable tube pressing device such as a pinch cock or forceps instead of a member that is fixedly attached to each flow path. In other words, using a detachable tube pressing tool such as a pinch cock or forceps, pressing the appropriate part of the tube and crushing the tube stops the liquid flow in the flow path or releases the pressure. It is also possible to allow liquid flow in the flow path.

  Furthermore, in the above example, the four first to fourth cocks were respectively installed at predetermined positions as the control means. It is not limited to the examples. For example, the second to fourth cocks were used as the electrolyte solution introduction control means, the first flow control means, and the second flow control means, respectively, but instead of these three cocks, a three-way cock was used. It is also possible to arrange in the branch part 49. Further, the first cock 40 serving as the bypass flow path control means is provided in the intermediate portion of the bypass flow path 34, but only in the vicinity of the upstream end of the bypass flow path 34 or upstream of the bypass flow path 34. It is also possible to install one control means in each of the vicinity of the side end and the vicinity of the downstream end.

  Furthermore, in the above-described embodiment, physiological saline is filled in the accommodation bag 46 as physiological saline. However, physiological saline filled in these containers is introduced into the body. However, a known material other than physiological saline can be used.

  In addition, in the above embodiment, the dialyzer using a dialyzer (dialyzer) has been exemplified as the blood purification device that is the subject of the present invention. Needless to say, the present invention can also be applied to diafiltration devices, filtration devices, and the like.

  In addition, although not listed one by one, the present invention can be implemented in a mode with various changes, modifications, improvements, and the like based on the knowledge of those skilled in the art. It goes without saying that all are included in the scope of the present invention without departing from the spirit of the invention.

It is a systematic diagram which shows an example of the blood purification apparatus according to this invention. It is front explanatory drawing which shows the partition instrument provided in the blood purification apparatus shown by FIG. It is front explanatory drawing which shows the compression instrument provided in the blood purification apparatus shown by FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 10 Dializer 12 Blood supply flow path 14 Blood return flow path 16 Arterial puncture needle 18 Venous puncture needle 20 Blood pump 22 Shunt blood vessel 24 Dialysate supply flow path 26 Dialysate discharge flow path 28 Arterial chamber 30 Vein chamber 32 Main line flow path 34 Bypass flow path 36 Upstream connection section 38 Downstream connection section 40 First cock 42, 50, 56, 58 Knob section 44 Electrolyte solution supply flow path 45 Communication port 46 Storage bag 47 Mounting hole 48 Second cock 49 Branch section 52 Third cock 54 Fourth cock 60 Partition device 62, 64 Partition plate 66 Claw portion 68, 70 Inner surface 72 Compression device 74 Compression plate 76 Arm portion 78 Cylindrical connecting portion 80 Rotating shaft 82 Torsion coil spring

Claims (5)

A purifier for purifying blood, a blood supply flow path for supplying blood to be purified to the purifier, and a blood provided on the blood supply flow path for delivering blood to the purifier A blood purification apparatus comprising: a pump means; and a blood return channel connected to the purifier and for returning blood purified by the purifier to the body,
And the downstream-side connecting portion located on the blood supply channel portion of the blood flow direction downstream side of the pump means and the upstream joint positioned in the blood supply channel portion of the blood flow direction upstream of the pump means A bypass flow path that bypasses the pump means;
A bypass flow path control means provided on the bypass flow path to allow or prevent liquid flow through the bypass flow path;
A container in which an electrolyte solution is accommodated, and an electrolyte solution supply channel that connects the container to the blood supply channel part upstream in the blood flow direction from the upstream connection portion; housed electrolyte solution, through electrolyte solution supply channel, and an electrolyte solution supply means so as to be introduced into the blood supply passage,
An electrolyte solution introduction control means the permissible from the electrolyte solution supply passage inflow of the electrolyte solution to the blood supply channel to prevents,
Before the winding was provided in the supply flow path, the electrolyte solution wherein the electrolyte solution first flow control means supply passage that is acceptable to the liquid flow in the blood flow direction upstream of the connected portion to prevent the supply means When,
Before the winding was provided in the supply flow path, the allowable said sites electrolyte solution supply channel is connected to the electrolyte solution supply means and the liquid flow between the said upstream joint of the bypass passage to the blocking Second distribution control means for
In the state where the pump means is operated, the opening and closing operation of the flow path by the bypass flow path control means, the electrolyte solution introduction control means, the first flow control means and the second flow control means The blood in the blood supply channel, the purifier, and the blood return channel is collected by the electrolyte solution introduced into the blood supply channel from the electrolyte solution supply means. Blood purification device. The container in the electrolyte solution supply means is disposed at a position higher than the blood supply channel, the purifier, and the blood return channel in the direction of gravity, and the electrolyte solution in the container has an action of gravity. under their blood supply passage, purifier, with the structure described is caused to supply to the blood return passage, the blood purification apparatus of claim 1, the recovery of the blood is performed. The container is configured by a flexible bag body having a variable volume, and the volume of the bag body is reduced as the electrolyte solution stored in the bag body flows out. The blood purification apparatus according to claim 1 or 2 . A partitioning means for partitioning the inside of the container in a liquid-tight manner is provided so as to be able to release the partitioning function, and exists in a portion of the container that is partitioned by the partitioning means on the side of the electrolyte solution supply channel communication side. 4. The blood purification apparatus according to claim 3 , wherein only the electrolyte solution is introduced into the blood supply channel through the electrolyte solution supply channel. The blood purification apparatus according to claim 3 or 4 , further comprising a pressing means for pressing the container from outside to increase an internal pressure of the electrolyte solution stored in the container.

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