JP5698010B2 - Blood purification apparatus and method of operating blood purification apparatus - Google Patents

Description

  The present invention relates to a blood purification apparatus and a method for operating the blood purification apparatus.

  For example, hemodialysis treatment is performed by a hemodialysis apparatus. As shown in FIG. 6, the hemodialysis apparatus normally returns blood to the blood supply channel 102 for supplying blood from the arterial puncture needle 100 to the blood purifier 101 and the blood from the blood purifier 101 to the vein puncture needle 103. The blood supply path 102 is provided with a blood pump 105 for delivering blood. Further, drip chambers 106 and 107 are provided in the blood supply channel 102 and the blood return channel 104. At the time of hemodialysis, the blood pump 105 is operated, the blood of the patient collected from the arterial puncture needle 100 is sent to the blood purifier 101 and purified, and then returned to the patient from the venipuncture needle 103.

  At the end of hemodialysis, it is necessary to return (return) blood remaining in the blood circuit to the patient. For this reason, an electrolyte liquid flow path 109 communicating with, for example, an electrolyte liquid back 108 is connected to the blood supply flow path 102 upstream of the blood pump 105. When returning blood, the blood supply flow from the electrolyte liquid flow path 109 is connected. The electrolyte solution is supplied to the path 102, the blood circuit is replaced with the electrolyte solution, and the blood in the blood circuit is returned to the patient.

  During hemodialysis, a small amount of blood repeatedly flows into and out of the electrolyte flow path 109 with a change in pressure in the blood supply flow path 102, and a part of the blood stays. Therefore, at the connection portion A with the blood supply flow path 102 in the electrolyte liquid flow path 109, the staying blood coagulates to form a so-called thrombus. Therefore, when returning blood, it is necessary to prevent this thrombus from entering the patient's body.

  Therefore, in the current return of blood, for example, first, the positive rotation of the blood pump 105 causes the electrolyte solution to flow from the electrolyte solution flow path 109 to the downstream side of the blood supply flow path 102 (blood pump 105 side). The downstream side of 102, the blood purifier 101, and the blood return channel 104 are replaced with the electrolyte solution, and the blood is returned to the patient from the venipuncture needle 103 side. At this time, the thrombus formed at the connection portion A with the blood supply channel 102 in the electrolyte solution channel 109 is pushed downstream to the blood supply channel 102. The thrombus is captured by the blood purifier 101, the drip chambers 106 and 107, and the like. After the thrombus has flowed to the downstream side, the electrolyte solution in the electrolyte solution channel 109 is flowed to the upstream side of the blood supply channel 102 (arterial puncture needle 100 side), and the upstream side is replaced with the electrolyte solution, and the upstream The blood on the side is returned to the patient from the arterial puncture needle 100 side.

Yuhei Hirasawa, Journal of Dialysis Society. 34 (9): 1277-1286, 2001

  However, in the above blood return method, there is a possibility that the thrombus formed at the connection portion of the electrolyte channel 109 with the blood supply channel 102 remains without flowing downstream of the blood supply channel 102. . In this case, there is a possibility that a thrombus may enter the patient's body from the arterial puncture needle 100 side when the electrolyte solution in the electrolyte solution flow path 109 is flowed to the upstream side of the blood supply flow path 102 (the arterial puncture needle 100 side). Therefore, as a precaution, a device for detecting a thrombus is attached upstream of the blood supply channel 102. An apparatus for detecting this thrombus is expensive.

  This invention is made | formed in view of this point, and it aims at providing the operating method of the blood purification apparatus which can prevent a blood clot from entering a patient's body at low cost, and a blood purification apparatus.

The present invention that achieves the above object includes a blood purifier for purifying blood, a blood supply channel for supplying blood from an arterial puncture needle to the blood purifier, and blood from the blood purifier to a vein puncture needle. A blood return channel for returning, a blood delivery device provided on the blood supply channel, for delivering blood to the blood purifier, and an electrolyte solution for replacing blood in the blood supply channel The blood purification apparatus having an electrolyte liquid flow path further includes an anticoagulant supply apparatus connected to the electrolyte liquid flow path for supplying blood anticoagulant liquid onto the electrolyte liquid flow path.

  According to the present invention, a blood anticoagulant can be supplied to a connection portion of the electrolyte solution flow passage with the blood supply flow passage, and thus it is possible to prevent thrombus formation at the connection portion. Thereby, since there is no need for an expensive device for detecting a thrombus, it is possible to prevent the thrombus from entering the patient's body at the time of returning blood. In addition, since complicated operation of the flow of blood or electrolyte solution is not required, it is possible to easily prevent thrombus from entering the patient's body when returning blood.

  The anticoagulant supply device includes an anticoagulant reservoir, one end connected to the anticoagulant reservoir, and the other end connected to the electrolyte channel, and the anticoagulant supply channel. An anticoagulant pump may be provided to send the anticoagulant from the coagulant reservoir to the electrolyte channel.

  The blood purification apparatus includes a second on-off valve provided upstream of a connection portion between the first on-off valve provided in the electrolyte solution flow path and the electrolyte solution flow path of the blood supply flow path. And closing the second on-off valve and closing the first on-off valve for a predetermined time in a state where the blood delivery device is operated in the forward direction. And a controller that causes the electrolyte solution to flow into the blood supply flow path by depressurizing the downstream side of the two on-off valves and then opening the first on-off valve. The path may be connected upstream of the blood delivery device in the blood supply channel.

  The control device opens the first on-off valve, closes the second on-off valve, operates the blood delivery device in the forward direction, and from the electrolyte solution channel to the blood supply channel. Supplying the electrolyte solution downstream of the connecting portion with the electrolyte solution channel, closing the first on-off valve, opening the second on-off valve, and operating the blood delivery device in the reverse direction; The electrolyte solution on the downstream side of the connection portion of the blood supply channel with the electrolyte solution channel may be supplied upstream of the connection portion.

  The blood purification apparatus compares the actual delivery amount of the anticoagulant solution by the anticoagulant pump and the scheduled delivery amount at regular intervals, and when the actual delivery amount is larger than the scheduled delivery amount, the actual delivery amount is You may further have a control apparatus which stops the said anticoagulation liquid pump until it corresponds to this scheduled delivery amount.

Another aspect of the present invention is a method for operating a blood purification apparatus, the blood purification apparatus comprising: a blood purification device for purifying blood; and a blood supply for supplying blood to the blood purification device from an arterial puncture needle A flow path, a blood return flow path for returning blood from the blood purifier to the venipuncture needle,
A blood delivery device that is provided on the blood supply channel and delivers blood to the blood purifier, and an electrolyte solution for replacing blood to the upstream side of the blood delivery device in the blood supply channel An electrolyte solution channel, an anticoagulant supply device for supplying an anticoagulant solution of blood onto the electrolyte solution channel, a first on-off valve provided in the electrolyte solution channel, and the blood supply channel A second on-off valve provided on the upstream side of the connection portion with the electrolyte solution flow path, closing the second on-off valve, and moving the blood delivery device in the forward direction. When the first on-off valve is closed for a certain period of time, the downstream side of the second on-off valve in the blood supply channel is decompressed, and then the first on-off valve is opened. By doing so, the electrolyte solution is supplied to the blood supply channel. Controller so as to enter is intended to operate.

  In the operating method of the blood purification apparatus, the control device causes the electrolyte solution to flow into the blood supply channel, then closes the first on-off valve, opens the second on-off valve, and The blood delivery device is operated in the reverse direction so that the electrolyte solution supplied to the downstream side of the connection portion in the blood supply channel is supplied to the upstream side of the connection portion in the blood supply channel. It may be.

  In the operating method of the blood purification apparatus, the anticoagulant supply device has an anticoagulant pump for sending the anticoagulant liquid from the anticoagulant reservoir to the blood supply channel through the anticoagulant supply channel. The control device compares the actual delivery amount of the anticoagulant liquid by the anticoagulant pump and the scheduled delivery amount at regular intervals, and when the actual delivery amount is larger than the scheduled delivery amount, the actual delivery amount The anticoagulant pump may be stopped until the value coincides with the scheduled delivery amount.

  According to the present invention, a thrombus can be prevented from entering the patient's body at a low cost.

It is explanatory drawing which shows the outline of a structure of the hemodialysis apparatus. It is explanatory drawing of the hemodialysis apparatus of the state which open | released the 1st on-off valve and closed the 2nd on-off valve. It is explanatory drawing of the hemodialysis apparatus of the state which closed the 1st on-off valve and opened the 2nd on-off valve. It is explanatory drawing of the hemodialysis apparatus of the state which closed the 1st on-off valve and the 2nd on-off valve. It is explanatory drawing of the hemodialysis apparatus in case the main tube of an electrolyte solution flow path is connected to the tube of a heparin solution supply flow path. It is explanatory drawing which shows the structure of the hemodialysis apparatus before improvement.

  Hereinafter, an example of an embodiment of the present invention will be described with reference to the drawings. FIG. 1 is an explanatory diagram showing an outline of the configuration of a hemodialysis apparatus 1 as a blood purification apparatus according to the present embodiment.

  The hemodialysis apparatus 1 includes a blood purifier 10 for purifying blood, a blood supply channel 12 for supplying blood from the arterial puncture needle 11 to the blood purifier 10, and blood from the blood purifier 10 to the vein puncture needle 13. A blood return channel 14 for returning the blood, a blood pump 15 provided on the blood supply channel 12 as a blood delivery device for delivering blood to the blood purifier 10, and a blood flow pump in the blood supply channel 12 The heparin solution which supplies the heparin solution as an anticoagulant of blood to the blood supply channel 12 and the electrolyte solution channel 16 for supplying the electrolyte solution of blood to the upstream side (arterial puncture needle 11 side) from 15 A supply device 17 and a control device 18 are included.

  The blood purifier 10 is, for example, a hollow fiber module that incorporates a hollow fiber membrane 19. Blood is passed through the primary side 10 a of the membrane 19, dialysate is passed through the secondary side 10 b, and unnecessary in the blood on the primary side 10 a. The substance can be taken into the dialysate on the secondary side 10b through the membrane 19 and the blood can be dialyzed.

  For example, soft tubes are used for the blood supply channel 12 and the blood return channel 14. The blood pump 15 is, for example, a tube pump, and can handle the tube of the blood supply flow path 12 to pump blood to the blood purifier 10 side. The blood pump 15 can rotate forward and backward.

  A drip chamber 30 is provided between the blood pump 15 and the blood purifier 10 in the blood supply channel 12. The blood return channel 14 is provided with a drip chamber 31.

  For example, one end of the electrolyte solution channel 16 is connected to the electrolyte solution bag 40 and the other end is connected to the blood supply channel 12. The electrolyte solution bag 40 is installed at a high position so that the electrolyte solution can freely fall.

  The heparin solution supply device 17 includes, for example, a heparin syringe 50 as an anticoagulant reservoir, a heparin solution line 51 as an anticoagulant supply channel for circulating the heparin solution, and a heparin solution pump 52 for delivering the heparin solution. The heparin solution line 51 has one end connected to the heparin syringe 50 and the other end connected to the electrolyte solution flow path 16.

  A first on-off valve 60 such as an electromagnetic valve is provided on the electrolyte liquid flow path 16 on the side of the electrolyte liquid back 40 from the connection portion with the electrolyte liquid flow path 16 in the heparin solution line 51. Further, a second opening / closing valve 61 such as an electromagnetic valve is provided upstream of the connection portion of the blood supply channel 12 with the electrolyte solution channel 16.

  The control device 18 controls the overall operation of the hemodialysis device 1. The control device 18 is a general-purpose computer, for example, and includes a storage unit, a calculation unit, a display unit, and the like. The control device 18 can control the operation of the blood pump 15, the heparin solution pump 52, the first on-off valve 60, the second on-off valve 61, etc., and can perform hemodialysis and blood return after the hemodialysis. .

  Next, an operation method of the hemodialysis apparatus 1 configured as described above will be described together with a hemodialysis process.

  At the time of hemodialysis, for example, as shown in FIG. 1, with the first on-off valve 60 closed and the second on-off valve 61 opened, the blood pump 15 is rotated forward, and the patient's blood is passed through the arterial puncture needle 11. Is sent to the blood purifier 10 through the blood supply channel 12. In blood purifier 10, unnecessary substances in the blood are removed. The blood purified through the blood purifier 10 is returned to the patient from the venipuncture needle 13 through the blood return channel 14.

  At the time of hemodialysis, the heparin solution flows from the heparin syringe 50 through the heparin solution line 51 and is supplied to the connection portion A of the electrolyte solution channel 16 with the blood supply channel 12. The heparin solution further passes through the blood supply channel 12, passes through the blood purifier 10, passes through the blood return channel 14, and enters the patient through the venipuncture needle 13. Thereby, the coagulation ability of blood in the patient's body is suppressed. Further, by supplying this heparin solution, the heparin concentration is remarkably increased in the connection portion A of the electrolyte solution flow channel 16 to the blood supply flow channel 12, and blood is coagulated in this portion during hemodialysis to generate a thrombus. It is prevented.

  After hemodialysis for a predetermined time, the blood pump 15 is stopped and the hemodialysis is finished. When the hemodialysis is finished, blood is returned to the patient to return the remaining blood in the blood circuit. When returning blood, as shown in FIG. 2, the first on-off valve 60 is opened, the second on-off valve 61 is closed, the blood pump 15 is rotated forward, and the electrolyte solution in the electrolyte solution back 40 flows into the electrolyte solution flow. It flows into the blood supply channel 12 through the channel 16. At this time, the electrolyte solution flows downstream of the connection portion A with the electrolyte solution channel 16 in the blood supply channel 12. As a result, blood on the downstream side of the connection portion A of the blood supply channel 12 is pushed by the electrolyte solution and returned from the venipuncture needle 13 side to the patient's body.

  Next, as shown in FIG. 3, the first on-off valve 60 is closed, the second on-off valve 61 is opened, and the blood pump 15 is reversely rotated. As a result, the electrolyte solution that has flowed downstream from the connection portion A of the blood supply flow path 12 is caused to flow upstream from the connection portion A, and the blood on the upstream side flows from the arterial puncture needle 11 into the patient's body. Returned.

  The supply of the electrolyte solution to the downstream side of the connection portion A of the blood supply channel 12 shown in FIG. 2 and the supply of the electrolyte solution to the upstream side shown in FIG. All the blood in the path 12, the blood purifier 10, and the blood return flow path 14 is returned to the body of the patient, and then the blood pump 15 is stopped and the blood return is completed. In addition, once the electrolyte solution is supplied to the downstream side of the connection portion A of the blood supply flow path 12, all the blood downstream of the connection portion A of the blood supply flow path 12 is returned to the patient's body. Thereafter, the supply of the electrolyte solution to the upstream side of the connection portion A of the blood supply channel 12 and the supply of the electrolyte solution to the downstream side of the connection portion A of the blood supply channel 12 may be repeated. .

  According to the present embodiment, the heparin solution, which is an anticoagulant solution, can be supplied to the connection portion A of the electrolyte solution flow channel 16 with the blood supply flow channel 12, so that the heparin concentration is significantly increased in the connection portion A. It is possible to prevent blood from coagulating and forming a thrombus at that portion. Thereby, since there is no need for an expensive device for detecting a thrombus, it is possible to prevent the thrombus from entering the patient's body at the time of returning blood. In addition, since complicated operation of the flow of blood or electrolyte solution is not required, it is possible to easily prevent thrombus from entering the patient's body when returning blood.

  In the present embodiment, since the existing heparin solution supply device 17 that is supplied to the blood supply channel 12 during hemodialysis and suppresses the coagulation ability of blood in the patient's body is used, the hemodialysis device 1 can be suppressed at low cost. . In the present invention, the existing heparin solution supply device 17 is not necessarily used, and may be provided separately.

  In the above embodiment, when the electrolyte solution is caused to flow downstream from the connection portion A in the blood supply channel 12, the control device 18 closes the second on-off valve 61 as shown in FIG. At the same time, with the blood pump 15 rotated forward, the first on-off valve 60 is closed for a certain period of time, the upstream side of the blood pump 15 is depressurized, and then the first on-off valve 60 is opened to supply the electrolyte solution. It may be allowed to flow into the blood supply channel 12. In such a case, the upstream side of the blood pump 15 temporarily becomes a negative pressure, and the electrolyte liquid flows into the blood supply channel 12 at a high flow rate by opening the first on-off valve 60. Even if there is, it is surely pushed downstream from the connection part A of the blood supply flow path 12 and then caught by, for example, the drip chamber 30 or the like. Thereby, even if a thrombus is generated, blood can be returned more safely without entering the patient's body. In particular, since the heparin concentration is high in the connection portion A between the electrolyte solution flow channel 16 and the blood supply flow channel 12, even if a thrombus is formed, the thrombus adheres to the flow channel wall near the connection portion A. The thrombus is easily peeled off from the flow path wall by the high flow rate electrolyte solution and flows in the direction of the blood pump 15. In this example, it is more preferable that the opening / closing of the first on-off valve 60 is repeated a plurality of times intermittently.

  In the above embodiment, the actual delivery amount of the heparin solution by the heparin solution pump 52 and the scheduled delivery amount are compared at regular intervals, and when the actual delivery amount is larger than the scheduled delivery amount, the actual delivery amount is The heparin solution pump 52 may be stopped until it matches the scheduled delivery amount. The actual delivery amount may be measured, for example, by measuring the decrease amount of the heparin solution in the heparin syringe 50 every 30 minutes. In such a case, for example, when the heparin solution has been sent more than expected into the blood supply channel 12 that has become negative pressure from the blood pump 15, the heparin solution supply amount per unit time to the blood supply channel 12 is appropriate. Adjusted to the correct amount.

  During hemodialysis, the portion of the blood supply channel 12 upstream of the blood pump 15 has a negative pressure lower than the atmospheric pressure, and the heparin solution supply channel 51 enters the blood supply channel 12. The actual delivery amount of the incoming heparin solution may be greater than the expected delivery amount. In the above example, even in such a case, the amount finally supplied into the blood supply channel 12 can be adjusted to an appropriate amount.

  The preferred embodiments of the present invention have been described above with reference to the accompanying drawings, but the present invention is not limited to such examples. It is obvious for those skilled in the art that various modifications or modifications can be conceived within the scope of the idea described in the claims, and these naturally belong to the technical scope of the present invention. It is understood.

  For example, in the present specification, the “electrolyte solution supply channel 16” includes not only the same tube connected to the electrolyte solution bag 40 directly connected to the blood supply channel 12, but also other tubes, such as Those connected to the blood supply channel 12 via the tube of the heparin solution supply channel 51 are also included. That is, as shown in FIG. 5, the tube of the heparin solution supply channel 51 is directly connected to the blood supply channel 12, and the main tube of the electrolyte solution supply channel 16 is connected to the tube of the heparin solution supply channel 51. May be. In such a case, the electrolyte solution supply channel is configured by the main tube of the electrolyte solution supply channel 16 and the tube of the heparin solution supply channel 51.

  In the above embodiment, the electrolyte solution supply channel 16 is connected to the electrolyte solution bag 40 at one end and supplies the electrolyte solution from the electrolyte solution bag 40 to the blood supply channel 12. Is applicable even if the supply source of the electrolyte solution is other. For example, the electrolyte supply channel 16 is connected to a dialysate supply channel connected to the secondary side of the blood purifier 10, and the blood supply channel 12 uses the dialysate supplied to the blood purifier 10 during dialysis as an electrolyte solution. It may be one that is supplied to. In the above embodiment, the electrolyte solution is sent to the blood supply channel 12 by the blood pump 15, but the present invention may be sent by other methods. For example, a pump may be provided in the electrolyte solution supply channel 16, and the electrolyte solution may be supplied to the blood supply channel 12 by the pump. In the above embodiment, the electrolyte solution supply channel 16 is connected to the upstream side of the blood pump 15 in the blood supply channel 12, but is connected to the other part of the blood supply channel 12. Also good. Further, a clamp may be provided on the upstream side of the connection part of the heparin solution supply channel 51 of the electrolyte solution supply channel 16. In such a case, the parin solution is supplied to the connection portion between the heparin solution supply flow channel 51 and the electrolyte solution supply flow channel 16 in a state where the upstream side of the electrolyte solution supply flow channel 16 is closed by the clamp. Heparin concentration can be increased.

  In this embodiment, a heparin solution is used as an anticoagulant. However, other liquids such as low molecular weight heparin and nafamostat mesylate may be used as long as they have a property of suppressing blood coagulation. Good. Furthermore, the present invention can be applied to blood purification apparatuses other than hemodialysis apparatuses.

(Experiment)
The presence or absence of thrombus formation at the connecting portion between the blood supply channel and the electrolyte solution channel, the blood purification device of the present invention, in the blood purification treatment of a total of 44 times for 12 dialysis patients, In a total of 268 blood purification treatments of 48 dialysis patients, visual evaluation was performed immediately before blood collection operation. As a result, in the blood purification apparatus of the present invention, thrombus was not observed in all blood purification treatments, and in the conventional blood purification apparatus, formation of thrombus was recognized in all blood purification treatments.

DESCRIPTION OF SYMBOLS 1 Hemodialysis apparatus 10 Blood purifier 11 Arterial puncture needle 12 Blood supply flow path 13 Venous puncture needle 14 Blood return flow path 15 Blood pump 16 Electrolyte flow path 17 Heparin solution supply apparatus 18 Control apparatus 60 First on-off valve 61 2 on-off valve A Connection part with blood supply flow path in electrolyte flow path

Claims (8)

A blood purifier that purifies the blood;
A blood supply flow path for supplying blood from the arterial puncture needle to the blood purifier;
A blood return channel for returning blood from the blood purifier to the venipuncture needle;
A blood delivery device provided on the blood supply flow path for delivering blood to the blood purifier;
In the blood purification device having an electrolyte solution flow channel for supplying an electrolyte solution for replacing blood to the blood supply channel,
A blood purification apparatus, further comprising an anticoagulant supply device connected to the electrolyte solution channel and configured to supply an anticoagulant solution of blood onto the electrolyte solution channel.   The anticoagulant supply device includes an anticoagulant reservoir, one end connected to the anticoagulant reservoir, and the other end connected to the electrolyte channel, and the anticoagulant supply channel. The blood purification apparatus according to claim 1, further comprising an anticoagulant pump for delivering an anticoagulant from a coagulant reservoir to the electrolyte channel. A first on-off valve provided in the electrolyte liquid flow path;
A second on-off valve provided upstream of a connection portion of the blood supply channel with the electrolyte solution channel;
The second on-off valve in the blood supply channel is closed by closing the first on-off valve for a certain period of time while the second on-off valve is closed and the blood delivery device is operated in the forward direction. A controller for depressurizing the downstream side of the on-off valve and then opening the first on-off valve to allow the electrolyte solution to flow into the blood supply channel;
The blood purification apparatus according to claim 2, wherein the electrolyte liquid flow path is connected upstream of the blood delivery apparatus in the blood supply flow path.   The control device opens the first on-off valve, closes the second on-off valve, operates the blood delivery device in the forward direction, and from the electrolyte solution channel to the blood supply channel. Supplying the electrolyte solution downstream of the connecting portion with the electrolyte solution channel, closing the first on-off valve, opening the second on-off valve, and operating the blood delivery device in the reverse direction; The blood purification apparatus according to claim 3, wherein the electrolyte solution downstream of a connection portion of the blood supply channel with the electrolyte solution channel is supplied upstream of the connection portion.   The actual delivery amount of the anticoagulant solution by the anticoagulant pump and the scheduled delivery amount are compared at regular intervals, and when the actual delivery amount is larger than the scheduled delivery amount, the actual delivery amount matches the scheduled delivery amount. The blood purification apparatus according to any one of claims 2 to 4, further comprising a control device that stops the anticoagulant liquid pump until it is done. A method of operating a blood purification device,
The blood purification device comprises:
A blood purifier that purifies the blood;
A blood supply flow path for supplying blood from the arterial puncture needle to the blood purifier;
A blood return channel for returning blood from the blood purifier to the venipuncture needle;
A blood delivery device provided on the blood supply flow path for delivering blood to the blood purifier;
An electrolyte solution channel for supplying an electrolyte solution for replacing blood to the upstream side of the blood delivery device in the blood supply channel;
An anticoagulant supply device for supplying an anticoagulant of blood onto the electrolyte channel,
A first on-off valve provided in the electrolyte liquid flow path;
A second on-off valve provided on the upstream side of the connection portion of the blood supply channel with the electrolyte solution channel,
The second on-off valve in the blood supply channel is closed by closing the first on-off valve for a certain period of time while the second on-off valve is closed and the blood delivery device is operated in the forward direction. A method for operating a blood purification apparatus, wherein the control device operates so as to cause the electrolyte solution to flow into the blood supply flow path by depressurizing the downstream side of the on-off valve and then opening the first on-off valve.   The control device causes the electrolyte solution to flow into the blood supply channel, then closes the first on-off valve, opens the second on-off valve, and operates the blood delivery device in the reverse direction. The blood purification device according to claim 6, wherein the electrolyte solution supplied downstream of the connection portion in the blood supply flow path is supplied upstream of the connection portion of the blood supply flow path. Operating method. The anticoagulant supply device has an anticoagulant liquid pump for sending the anticoagulant liquid from the anticoagulant reservoir to the blood supply channel through the anticoagulant supply channel,
The control device compares the actual amount of anticoagulant liquid delivered by the anticoagulant liquid pump with the scheduled amount delivered at regular intervals, and when the actual amount delivered is greater than the scheduled amount delivered, the actual amount delivered is 8. The method for operating a blood purification apparatus according to claim 6 or 7, wherein the anticoagulant pump is stopped until it matches a scheduled delivery amount.

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