JP5867200B2 - Program and information processing apparatus - Google Patents

Description

  The present invention relates to a process for supporting determination of an injection volume in medicine.

  Peritoneal dialysis is a treatment for renal failure, which involves injecting dialysate into the abdominal cavity surrounded by the peritoneum and draining the waste fluid in the abdominal cavity, thereby removing waste and water in the blood. To be. Peritoneal dialysis includes the CAPD method (Continuous Ambulatory Peritoneal Dialysis) and the APD method (Automated Peritoneal Dialysis), which can be performed by each patient at home, at work, etc. It can be done.

  The APD method is a therapy suitable for the patient to change the peritoneal dialysate automatically using an automatic peritoneal dialysis device, particularly at home. Automatically collect and inject new dialysate automatically. The CAPD method is a therapy suitable for a patient to manually replace peritoneal dialysis fluid at home or at work, and can encourage the patient to return to society. In the CAPD method, a patient manually sets a waste liquid bag and a liquid injection bag, collects the liquid waste from the patient's peritoneum or intraperitoneal cavity, and then injects the dialysate in the liquid injection bag into the peritoneum or intraperitoneal cavity. .

  Known peritoneal dialysis machines include a dialyzer body and a dialysate circuit. The dialysate circuit includes a plurality of dialysate bags, a warming dialysate bag, a transfer tube set, a cassette, a reservoir bag, a plurality of drainage bags, and each tube. The dialysis machine main body includes a bag storage unit, a clamp unit, a control unit, a display unit, an operation unit, and a memory. In the peritoneal dialysis machine, there are an automatic mode in which the dialysate remaining in the dialysate bag is automatically transferred to the drainage bag after completion of dialysis, and a manual mode in which whether or not to perform the transfer can be manually selected. It can be set, and it can be set to the re-drainage mode in which the remaining liquid can be drained again after the final drainage. Thereby, dialysis treatment can be automated.

Japanese Patent Laid-Open No. 10-234849

  The known peritoneal dialysis machine is applied to the APD method in which a specific amount of dialysate is injected at a time, and the target dialysate effluent is measured by measuring the weight of the dialysate injection bag and the waste solution bag. The flow rate of infusion of dialysate into the patient's peritoneum is controlled so that the volume is sufficient. However, known peritoneal dialysis devices are not applicable to the CAPD method.

  The inventor needs (necessity) to support the determination of each dialysis fluid injection amount so that the dialysis fluid injection amount satisfies the required amount for one day in the CAPD method of peritoneal dialysis therapy. Recognized.

  The purpose of the embodiment is to be able to assist in determining each dialysate injection volume to meet the minimum daily dose.

According to one aspect of the embodiment, the number N of dialysate exchanges per day of the subject, the minimum total liquid injection amount T per day, the allowable range of the liquid injection amount per time, the previous day, / Or the lowest injection volume Pm of the m-th in continuous N dialysate exchanges ( where N is a natural number, 1 based on the previous injection volume on each day and the scheduled injection volume on each day) ≦ m ≦ N) , and in that case, the total Tr of the past latest (m−1) injection amount and the planned injection amount for the next (N−m) subsequent injections is obtained, and the lowest total injection amount is obtained. A value obtained by subtracting the total Tr from the liquid amount T is obtained as the m-th minimum liquid injection amount Pm, and a plurality of injections equal to or more than the minimum liquid injection amount Pm within the allowable range of the liquid injection amount per time are obtained. A program for causing the information processing apparatus to execute a process of presenting the liquid amount Pi as an option for the m-th injection amount is provided.

  According to one aspect of the embodiment, it is possible to assist in determining the dialysis fluid injection amount for each time so as to satisfy the minimum amount for one day.

FIG. 1 illustrates an example of a schematic arrangement of an information processing apparatus, a clamp control circuit, a weight measurement circuit, a weight scale, a branch tube, and the like applicable to the CAPD method according to the embodiment. 2A and 2B show examples of the structure of each clamp. FIG. 3 shows an example of a schematic configuration of the information processing apparatus. FIG. 4 shows an example of a schematic configuration of the processor of the information processing apparatus. FIG. 5 shows an example of a flowchart for processing that is executed by the information processing apparatus and supports the user's dialysate exchange operation each time. FIG. 6A shows an example of a plurality of injection levels representing the permissible range in one dialysis fluid injection and the respective injection amounts as other initial setting values. FIG. 6B shows an example of the dialysate concentration as the initial set value. FIG. 7 shows an example of initial setting values for state determination and state control set in the information processing apparatus. FIG. 8 shows an example of a table of a daily dialysate exchange plan for a patient as an initial value of the day set in the information processing apparatus. FIG. 9 shows an example of the change in the measured value of the weight of the drainage bag in the weighing scale received by the weighing circuit in one dialysate exchange according to the embodiment. FIG. 10 shows an example of a flowchart for the process for supporting the determination of the injection amount of the dialysate in each dialysate exchange included in step 400 of FIG. FIG. 11 shows an example of a screen that displays a plurality of candidate liquid injection amounts displayed by the information processing apparatus. FIG. 12 shows an example of specific processing in step 440 of FIG. 13A and 13B show an example of specific processing in step 450 (state determination control) of FIG. (Explained in Figure 13A) FIG. 14 shows an example of a monitoring screen displayed by the information processing apparatus when the state is liquid injection adjustment. FIG. 15 shows an example of data in a recording file related to the patient's injection volume.

The objects and advantages of the invention will be realized and attained by means of the elements and combinations particularly pointed out in the appended claims.
It is understood that the foregoing general description and the following detailed description are exemplary and explanatory only and are not intended to limit the invention.

  Non-limiting embodiments of the present invention will be described with reference to the drawings. In the drawings, similar components and elements have the same reference numerals.

  In the CAPD method, a patient performs dialysate exchange several times during the day, for example, every 4 to 12 hours. One dialysate exchange takes approximately 30 minutes to 1 hour. The number of dialysate exchanges per day depends on the patient, for example, 3-5 times, 4 times, etc. In the CAPD method, each patient may determine the total amount of dialysate injected per day and the range of each dialysate infused amount within a certain allowable range. Therefore, the patient can adjust the injection volume at each time according to the schedule or physical condition of the day. However, even if the injection volume of each dialysate falls within a certain allowable range, it may happen that the actual total dialysate injection volume per day does not meet the minimum daily amount.

  Also, for example, when the patient adjusts the amount of dialysate, the standard amount of dialysate in the injection bag is intentionally changed due to an error in opening / closing the clamp or intentionally because of poor physical condition. There are cases where excessive dialysate is not injected by discarding excessively into the waste solution bag. The dialysis record of each patient is checked by a doctor at the time of consultation once or twice a month, but the dialysis record is created by hand by each patient, is difficult to see, may contain errors, and there is no listing, so dialysate It may be overlooked that the injection amount of was insufficient.

  The inventor needs (necessity) to support the CAPD method to determine the dialysis fluid injection volume for each patient so that the dialysis fluid injection volume for each patient satisfies the minimum daily dose for each patient. Recognized. In addition, in the CAPD method, the inventor can advantageously control the start and end of each discharge of the waste liquid and the injection of the dialysate as automatically as possible to prevent an operation error or an intentional undesirable operation. I recognized.

  In the normal CAPD method, the patient first connects the connecting end of the catheter tube on the patient side to the drainage bag via the luer connector / twist clamp, and places the drainage bag at a position lower than the abdominal cavity. Close the injection side clamp and release the waste side clamp, luer connector and twist clamp. Thereby, the effluent containing the previous dialysis fluid in the abdominal cavity is discharged with a drop. Next, the patient measures the weight of the waste liquid bag with a spring gauge or the like, and calculates and records the amount of waste liquid by subtracting the weight of the empty waste liquid bag (tare) from the total weight of the waste liquid bag.

  Next, the patient hangs the infusion bag containing the standard amount of dialysate on a spring scale higher than the abdominal cavity, closes the luer connector and twist clamp, releases the infusion side clamp, and drops the infusion bag from the infusion bag. Start discharging dialysate into the waste bag. The patient closes the liquid injection side clamp when the weight of the liquid injection bag is reduced to the amount of the liquid injection at that time. The patient records the volume of infusion. The patient then closes the waste side clamp, releases the injection side clamp and the luer connector twist clamp, and injects the dialysate into the abdominal cavity with a drop. After the dialysate infusion is completed, the patient closes the infusion side clamp and the luer connector / twist clamp clamp. The patient then removes the dialysate bag and puts a cap on the connecting end of the catheter tube to complete the dialysate exchange.

  FIG. 1 shows an example of a schematic arrangement of an information processing apparatus 10, a clamp control circuit 20, a weight measurement circuit 30, a weight scale 40, a branch tube 50, and the like applicable to the CAPD method according to the embodiment. .

  In FIG. 1, the injection bag or dialysate bag 52 is connected via a branch tube 50 to a catheter tube (peritoneal catheter) 56 that leads into the abdominal cavity of a patient or a subject and a drainage bag 54. The branch tube 50 is provided with clamps or clamps 22, 23, 24 for opening and closing a flow path between the injection bag 52, the drainage bag 54, and the catheter tube 56, respectively. The mechanical opening and closing of the clamps 22, 23 and 24 is controlled by the clamp control circuit 20.

  2A and 2B show examples of the structure of each of the clamps 22, 23 and 24. FIG. Each of the clamps 22, 23, 24 includes, for example, a cam 26 and a tube holding portion 58 that are driven by a step motor (not shown). Each of the clamps 22, 23, and 24 is assembled to open and close each flow path of the branch tube 50 by pressing or releasing the tube 50 against the tube holding portion 58 by the rotation of the cam 26 by the step motor. ing. The rotation or angle of the cam 26 may be controlled by adjusting the rotation angle of the stepping motor by the clamp control circuit 20.

  The weight measurement circuit 30 periodically detects the data of the weight measurement values from the weight measurement circuit 40, for example, at intervals of 1 second, and transmits the data to the information processing apparatus 10 via the cable 7 such as a USB cable. The information processing apparatus 10 supplies a control signal to the clamp control circuit 20 via a cable 7 such as a USB cable.

  The information processing apparatus 10 includes, for example, a CPU (Central Processing Unit), a main storage device, a hard disk drive (HDD), a semiconductor memory, a bus, an input device, an output device, a communication interface, a drive for reading a recording medium, and the like. Or it may be a device. The information processing apparatus 10 may be, for example, a personal computer or a tablet terminal.

FIG. 3 shows an example of a schematic configuration of the information processing apparatus 10.
In FIG. 3, the information processing apparatus 10 is coupled to a clamp control circuit 20, a weight measurement circuit 30, and a printer 70 via a cable 7 such as a USB cable. Further, the information processing apparatus 10 may be connected to the server apparatus 80 via the network 5. The network 5 may include the Internet, a public switched telephone network (PSTN), a packet switched network (PSN), ISDN, and / or a mobile communication network. The information processing apparatus 10 may transmit the dialysis record data to the server apparatus 80 via the network 5 together with information on the date and time of each dialysis fluid exchange. In this case, the server device 80 receives, stores, and manages dialysis record data together with date and time information.

  3, the information processing apparatus 10 may include a processor 112, a memory 114, an input / output interface (I / O) 116, an internal bus, and the like. The processor 112 may be a CPU (Central Processing Unit) for a computer. The processor 112 and memory 114 are coupled to an input / output interface 116. The memory 114 includes, for example, a main storage device and a semiconductor memory. The information processing apparatus 10 further includes a display device (DSP) 122, an input unit or input device 126, a recording medium reading drive 128, and a hard disk drive (HDD) coupled to an input / output interface (I / O) 116. ) 130 may be included. The input unit 126 may include, for example, a keyboard, a pointing device such as a mouse or a touch pad, and a touch panel. The drive 128 may be for reading a recording medium 129 such as an optical disc on which a program is recorded. The information processing apparatus 10 may further include a USB interface (USB I / F) 142 and a network interface (NW I / F) 144 coupled to an input / output interface (I / O) 116.

  The processor 112 may be a dedicated processor implemented as, for example, an integrated circuit that includes dialysis therapy support functions. Further, the processor 112 may operate according to an application program stored in the memory 114 and / or the hard disk drive 130 and including a dialysis therapy support function. The application program may be stored in the recording medium 129, read from the recording medium 129 by the drive 128, and installed in the information processing apparatus 10.

  The information processing apparatus 10 may be coupled to the clamp control circuit 20, the weight measurement circuit 30, and the printer 70 via the USB interface 142 and the USB cable 7. The information processing apparatus 10 may be connected to the server apparatus 80 via the network interface 144 and the network 5.

  FIG. 4 shows an example of a schematic configuration of the processor 112 of the information processing apparatus 10.

  The processor 112 includes, for example, a control unit 1120, a setting unit 1122, a liquid injection amount calculation unit 1124, a presentation unit 1126, a measurement value management unit 1128, a filtering unit 1130, a state determination control unit 1132, a display processing unit 1134, and an end processing unit 1136. And other processing units 1140 may be included. The processing unit 1140 may include a clock indicating the date and time. The control unit 1120 includes a setting unit 1122, a liquid injection amount calculation unit 1124, a presentation unit 1126, a measurement value management unit 1128, a filtering unit 1130, a state determination control unit 1132, a display processing unit 1134, an end processing unit 1136, and a processing unit 1140. Control signals may be provided to control the operation of these elements.

  FIG. 5 shows an example of a flowchart for processing executed by the information processing apparatus 10 to support each dialysate exchange operation of a user such as a patient or a subject. In the following description, it is assumed that the patient or the subject himself / herself may be a user such as the information processing apparatus 10. However, the user such as the information processing apparatus 10 may be an operator different from the patient or the subject.

  Referring to FIG. 5, in step 400, the processor 112 (or its setting unit 1122) of the information processing apparatus 10 performs initial settings for waste fluid discharge, dialysis fluid injection, and dialysis record storage in accordance with user input operations. Do. The processor 112 (setting unit 1122) stores setting information set by the user in a recording file in the hard disk drive 130 or the memory 114.

  In the initial setting, the processor 112 (setting unit 1122), for example, specifies the standard amount S of the injection bag 52, each threshold value, the daily dialysate replacement number N, the scheduled injection amount Pf each time, the dialysate concentration, and the like. Let the user input information. The processor 112 (or the liquid injection amount calculation unit 1124) calculates the minimum liquid injection amount Pm of this time (m-th time) based on the input information and information such as the past liquid injection amount (actual result) Pp. . The processor 112 (or its presentation unit 1126) causes the display device 122 to display and select one or more current injection amount values Pi based on the lowest injection amount Pm. The waste liquid bag weight threshold value among the plurality of threshold values is, for example, the tare weight (g) of the empty waste liquid bag 54. Further, as the information such as the standard amount S of the injection bag 52, the waste solution bag weight threshold value, the daily dialysate replacement number N, etc., respective default values, for example, 2000 g, 140 g, 4 times, etc. may be displayed. . The processor 112 (setting unit 1122) stores setting information such as the standard amount S of the liquid injection bag, each threshold value, and the current liquid injection amount Pd in the recording file of the hard disk drive 130 or the memory 114.

  FIG. 6A shows a plurality of injection levels (small, light, normal, and large) representing the allowable range in one dialysate injection as other initial setting values, and the respective injection amounts R1, R2,. -The example of Rs (1000g-2000g) is shown. FIG. 6B shows an example of the dialysate concentration (for example, 1.5 and 2.5) as the initial set value.

  FIG. 7 illustrates an example of initial setting values for state determination and state control that are set in the information processing apparatus 10.

On the initial value setting screen, for example, the user sets initial values for state determination and state control as follows. For example, 10 (seconds or times) is set as a delay amount (clamp control delay amount) when the clamp is controlled to open and close. Here, “times” represents the number of times of weight measurement sampling. For example, 2 (g) is set as the flow rate fluctuation threshold value for determining or confirming the end of waste liquid discharge, the start of liquid injection adjustment, and the end of liquid injection adjustment. For example, 18 (seconds or times) is set as the waste liquid end threshold value of the state duration time for determining the end of the waste liquid discharge. For example, 6 (seconds or times) is set as the adjustment start threshold value of the state duration time for confirming the start of liquid injection adjustment. For example, 20 (seconds or times) is set as the injection supply start threshold / adjustment interruption threshold of the state continuation time for confirming the end of the injection adjustment or the start of injection supply. Further, for example, 10 (min) is set as the shortest waste liquid discharge time, 25 (min) is set as the longest waste liquid discharge time, and 0 (g) is set as the target minimum water removal amount. In addition, as the standard amount S of the dialysate in the infusion bag, for example, 2000 (g), for example, the maximum total infusion amount T _max for the day, for example, 8000 (g), for the minimum total infusion amount T _min for the day, for example 5400 (g) is set. These initial values may be displayed by default.

  FIG. 8 shows an example of a table of the dialysate replacement plan for a certain day of the patient as the initial value of the day set in the information processing apparatus 10.

In FIG. 8, the daily dialysate replacement plan includes, for example, information on the injection volume Pf for each time, the minimum total injection volume P _{min for each day} , and the concentration of the dialysate, from the first to the fourth time. Contains. One day of dialysate replacement plan is, for example, 1400 g of the injection liquid with a concentration of 1.5 as the first time, 1500 g of the injection liquid with the concentration of 1.5 as the second time, and 2.5 ml of the concentration as the third time. 1500g, and the fourth injection contains 1500g of liquid injection with a concentration of 1.5.

  Referring again to FIG. 5, in step 432 after step 400 (initial setting), the processor 112 (or its measurement value processing unit 1128) reads the current measurement value of the weight of the waste liquid bag 54 from the weight measurement circuit 30. . The reading of the measurement value may be performed periodically, for example, every second. In step 434, the processor 112 (measurement value processing unit 1128) compares the measurement value with a threshold value and determines whether or not the measurement value is equal to or greater than the threshold value. The threshold value may be, for example, the tare weight of the empty waste liquid bag 54. If it is determined that the measured value is greater than or equal to the threshold value, the procedure proceeds to step 440. If it is determined that the measured value is not greater than or less than the threshold, the procedure proceeds to step 436. For example, when the waste liquid bag 54 is dropped from the weighing scale 40 when the injection of dialysate is continued or finished, the measured value of the weighing scale 40 becomes 0 (zero), and the measured value is the threshold value. It is determined that it is not above.

  In step 440, the processor 112 (or its filtering unit 1130) filters or filters the received measurement value to generate a corrected measurement value. Thereby, the local fluctuation | variation with respect to the elapsed time of the original measured value of the weight scale 40 is suppressed. The processor 112 (filtering unit 1130) further determines a period during which each state can be determined for preventing an erroneous state determination and performing an appropriate state determination in determination and confirmation of a state such as waste liquid discharge and injection adjustment. Includes counter function to show. Accordingly, it is possible to determine and confirm the state of waste liquid discharge, liquid injection adjustment, and the like, excluding local excessive or excessive fluctuations with respect to the elapsed time of the measurement value.

  The local fluctuation may occur, for example, when a patient or the like in the waste liquid moves the body or the bags 52 and 54. The force generated by the movement or vibration affects the measurement value of the weigh scale 40 as a variation in a drop between the catheter tube 56, the waste solution bag 52 and the injection bag 54, or a change in the weight of the waste solution bag 54. There is. Moreover, the local fluctuation | variation may arise when supply of the liquid injection from the liquid injection bag 52 is obstructed by the bubble produced in the branch tube 50, for example.

  In step 450, the processor 112 (or its state determination control unit 1132) determines the current stage (phase) from the start of the drainage of the waste fluid from the catheter tube 56 to the injection of the dialysate into the catheter tube 56 and the waste bag. The transition of the weight measurement value of 54 and its change are monitored. The processor 112 (state determination control unit 1132) further determines a state such as the start, continuation, or end of each stage based on the transition and change of the measured value, and the clamp 22 according to the state of each stage. A control signal for controlling the opening and closing of 23 and 24 is generated.

  In step 460, the processor 112 (or its display processing unit 1134) measures the set value, the current stage and state from the waste liquid discharge to the dialysate injection, and the weight of the waste liquid bag 54 in the current dialysate exchange. The transition of the value and the like are displayed on the display device 122. Thereafter, the procedure returns to Step 432. Steps 432, 434, 440 to 460 are repeated until the waste bag 54 is lowered from the weighing scale 40 and the weight measurement value becomes smaller than the threshold value.

  In step 436, the processor 112 (measurement value processing unit 1128) determines whether or not the current stage is “initial” before the start of waste liquid discharge. If it is determined that the current stage is “initial”, the procedure returns to step 432. If it is determined that the current stage is not “initial”, the procedure proceeds to step 470.

  In step 470, the processor 112 (or its end processing unit 1136) indicates the number of times this dialysate replacement is performed on the current day, the current operation completion date and time, the current injection amount (actual) Pd, and the like on the hard disk. Save to a recording file in drive 130 or memory 114 to complete the process. Thereafter, the procedure exits the routine of FIG.

  FIG. 9 shows an example of the change in the measured value of the weight of the drainage bag 54 in the weighing scale 40 received by the weight measuring circuit 30 in one dialysate exchange according to the embodiment. The change in the measured value is a change in the period from the start of the waste liquid discharge to the end of the liquid supply or the end of the liquid supply in steps 432, 434, and 440 to 460 in FIG. The measurement value may be the measurement value corrected in step 440 (filtering process) in FIG.

  Referring to FIGS. 1 and 9, the user operates the information processing apparatus 10 to start discharging the waste liquid from the patient's catheter tube 56 to the drain bag 54. The processor 112 of the information processing apparatus 10 determines that the current state is the start state of the waste liquid discharge stage, controls the clamp control circuit 20 according to the state, and drains the liquid from the catheter tube 56 of the patient. The discharge of the dialyzed waste liquid into the bag 54 is started. Thereby, from the start point of the time axis (horizontal axis), the measured value of the weight of the waste liquid bag 54 by the weigh scale 40 starts to gradually increase from the weight of the empty waste liquid bag 54.

  Thereafter, for example, when the increase in the weight of the waste liquid bag 54 becomes approximately 0 (zero) g after about 20 minutes, the processor 112 indicates that the current state is the end state of the waste liquid discharge stage of the liquid injection bag 52. Is determined. The processor 112 controls the clamp control circuit 20 according to the state, and stops waste liquid discharge. Next, the processor 112 determines that the current state is a start state of adjusting the injection amount of the dialysate into the infusion bag 52, and controls the clamp control circuit 20 to discharge the infusion from the infusion bag 52. The discharge of the adjusted amount of dialysate to the bag 54 is started. As a result, the measured value of the weight of the waste liquid bag 54 by the weigh scale 40 starts to gradually increase again from the weight of the waste liquid bag 54 after the waste liquid is discharged. When the weight of the waste liquid bag 54 begins to increase again, the processor 112 confirms that the current state is the start state of the liquid injection adjustment stage.

  Thereafter, when the weight of the waste liquid bag 54 increases by the adjustment amount, that is, when the amount D of the dialysate discharged to the drainage bag 54 reaches the adjustment amount, the processor 112 determines that the current state is the stage of liquid injection adjustment. It is determined that this is the end state. Here, the adjustment amount is a value obtained by subtracting the injection amount Pd of the dialysate to the patient this time from the standard amount S of the injection bag 52 (S-Pd). The processor 112 controls the clamp control circuit 20 according to the state, and stops the discharge of the dialysate from the injection bag 52 to the drain bag 54.

  Thereafter, when the amount of increase in the weight of the waste liquid bag 54 becomes approximately 0 (zero) g, the processor 112 confirms that the current state is the end state of the liquid injection adjustment stage, and supplies the liquid supply. It is determined that the stage is in the start state. The processor 112 controls the clamp control circuit 20 according to the state, and starts supply of the injection (dialysis solution) from the injection bag 52 to the patient's catheter tube 56. While the liquid supply is continuing, the processor 112 determines that the current state is continuing the liquid supply stage.

  Thereafter, when the waste bag 54 is removed from the scale 40 by the user and its weight becomes approximately 0 (zero) g, the processor 112 stores various data in a recording file in the hard disk drive 130 or the memory 114. Then, a process for ending support for dialysate exchange is performed. After the injection of the dialysate from the injection bag 52 into the abdominal cavity of the patient is completed, the user closes the clamps 22 and 24 manually or by operating the information processing apparatus 10 to complete the dialysate exchange at that time. . The user drops the waste liquid bag 54 from the weighing scale 40 after starting the liquid supply or after completing the liquid supply, and disposes of the waste liquid bag 54.

  FIG. 10 shows an example of a flowchart for the process for supporting the determination of the injection amount of dialysate in each dialysate exchange included in step 400 (initial setting) of FIG.

In FIG. 10, it is assumed that the patient performs dialysate exchange N times in one day or 24 hours. It is considered that each dialysate exchange of N times a day is performed at approximately the same time zone every day. The injection amount of the dialysate at each time is determined in advance in the dialysate exchange plan, but can be changed at each time within an allowable range. In steps 402 to 416, the total liquid injection amount T for which the total of the liquid injection amount for any continuous N times or 24 hours in the period of 2 days (2 × N times) including the current day and the previous day is the lowest in the day It is desirable to determine the minimum amount of injection at this time so that it is not less than _min . Here, the two-day period includes 2 × N dialysate exchanges, and the first of any consecutive N times is the second to N times of N times the previous day and the first time of N times of the day. It may be any of the times.

When this time is the m-th of the arbitrary continuous N times, the minimum injection amount Pm of the m-th time is obtained, for example, by the following equation (where N is a natural number, 1 ≦ m ≦ N).
Minimum injection volume Pm this time (mth)
= Total daily total liquid injection volume Tr for N consecutive times excluding the minimum total liquid injection volume T _min -m
= Total Tr in the liquid injection amount for the remaining (N-1) times other than the lowest total liquid injection amount T _min -m for the first day
= Minimum total injection volume T _min per day
-(Total Tp of the previous (m-1) injection volume + Total Tf of the next (N-m) injection volume)

Here, the past liquid injection volume is data based on actual results, and the liquid injection volume after the next time is, for example, the planned liquid injection volume in the table of the dialysate replacement plan in FIG. The N times may be, for example, consecutive N times spanning the previous day and the current day in 2 × N times on the two days of the current day and the previous day, or may be N consecutive times only on the current day. When the m-th time this time is the first time of the day, m = N is set, and the past (N-1) times may be the second time to the previous day (N-1) times. If the current m-th time is any one of N-th to (N-1) th of N times on the day, set m = N, and the remaining (N-1) times in N consecutive times It may be the past past (N-1) times across the day.

  Referring to FIG. 10, in step 402, the processor 112 (injection amount calculation unit 1124) determines whether or not the current dialysate replacement is the first time in one day. If it is determined that the current dialysate exchange is the first time, the procedure proceeds to step 412. If it is determined that the current dialysate exchange is not the first time, the procedure proceeds to step 404.

  In step 404, the processor 112 (injection amount calculation unit 1124) determines whether or not the current dialysate replacement is the last time in one day. If it is determined that the current dialysate exchange is the final time, the procedure proceeds to step 414. If it is determined that the current dialysate exchange is not the final time, the procedure proceeds to step 416.

In step 412, the processor 112 (injection amount calculation unit 1124) determines the initial minimum injection amount Pm this time, that is, the current day, from the minimum total injection amount T _{min of the} day, as shown in the following equation: It may be set to a value obtained by subtracting the difference between the total liquid injection volume (actual) of the previous day and the initial liquid injection volume (actual) of the previous day.
Minimum injection volume Pm this time (first time of the day)
= Minimum total liquid injection volume for one day T _min- (Total liquid injection volume for the previous day (actual)-Initial liquid injection volume for the previous day (actual))
= The lowest total liquid injection volume T _min per day -The total Tr of the liquid injection volume at the last (N-1) times of the previous day
As a result, the total (actual) Tr of the second and subsequent injections of the previous day and the initial minimum injection volume Pm of the day, that is, the total of the injection volume for approximately 24 hours is the lowest total of the day. can be set such that the injected amount T _min.

For example, it is assumed that the minimum total injection amount T _min and the number N of times per day and the injection amount N times the previous day are as shown in the table of FIG. In this case, the minimum total injection amount per day is T _min = 5400 g, and the last Tr (N-1) times of the previous day = total injection volume of 3 times is 4500 g, so that the lowest of the first injection on the day Will be Pm = 5400 g-4500 g = 900 g.

In step 414, the processor 112 (injected amount calculating unit 1124) is the lowest pouring quantity Pm of the last round of this or the day, as in the following equation, from the lowest of the total pouring weight _{T min} daily The total (actual) Tr of the past liquid injection volume on the day may be set to a value obtained by subtraction.
Minimum injection volume Pm this time (Nth time on the day)
= Minimum daily total liquid injection volume _Tmin- Total liquid injection volume for the day (actual) Tr
= Minimum total liquid injection volume T _min per day -Total Tr of liquid injection volume of the past (N-1) times of the day
Thereby, it is possible that the total of the day of the pouring amount (actual) is set to be the lowest of the total liquid injection amount T _min of 1 day.

For example, it is assumed that the minimum total injection amount T _min and the number N of times per day and the liquid injection amount in the past (N-1) times on the day are as shown in the table of FIG. In this case, the minimum total injection amount T _min = 5400 g, and the final (N−1) times = total injection amount of 3 times Tr is 4400 g. The minimum liquid injection amount is Pm = 5400 g-4400 g = 1000 g.

In step 416, the processor 112 (injection amount calculation unit 1124) determines the current minimum injection amount Pm from the minimum total injection amount T _min of the day as shown in the following formula, It is set to a value obtained by subtracting the sum Tr of the total liquid injection amount (actual) and the total liquid injection amount (planned) from the next time on that day.
Minimum injection volume Pm this time (mth day)
= Minimum total liquid injection volume T _min per _day- (Total Tp of past liquid injection volume (actual) on that day + Total liquid injection volume Tf on and after that day)
= The lowest total liquid injection volume T _{min of the} day (total Tp of liquid injection volume of the past (m-1) times of the current day + total Tf of liquid injection scheduled for the next (N-m) and subsequent liquids of the current day)

Here, even if the total Tf of the next and subsequent (N−m) scheduled injection amounts in the N times on the day is used as the total Tf of the next and subsequent (N−m) injections, as described above, or Corresponding to this, the total Tp ′ of the (N−m) -th to N-th liquid injection amount (actual results) after the next N times on the previous day, that is, N times on the previous day may be used. Alternatively, as the total Tf of the scheduled injection volume after the next time (N−m times), the remaining total number (N) of the value (quotient) obtained by dividing the minimum total liquid injection volume T _min per day by the number N of times per day A value obtained by multiplying -m) may be used.

For example, the mth time this time is m = 2 times of N = 4 times a day, the lowest total injection amount _Tmin , the past (N−m) on that day = the amount of injections once, and the next time on the day (N -M) = It is assumed that the planned injection volume of 2 times is as shown in the table of FIG. In this case, the minimum total injection amount T _min = 5400 g, and the past (m−1) = total injection amount for one injection Tp (1400 g) and the next and subsequent (N−m) = 2 scheduled injections The sum Tr of the total liquid amount Tf (3000 g) is Tr = 4400 g. Therefore, the minimum injection amount for the second time m = 2 is Pm = 5400 g-4400 g = 1000 g.

  In step 418, the processor 112 (presentation unit 1126) selects the current minimum injection volume from among a plurality (s) of options (R 1, R 2,... Rs) within the allowable range of the injection volume per time. One or more candidate liquid injection amounts Pi of Pm or more are displayed on the display device 122 as options. When s options are (R1, R2,... Rs), the candidate liquid injection amount Pi is expressed by Pi = (Ri, R (i + 1),... Rs), Ri ≧ Pm. . The user operates the input unit 126 to select an appropriate liquid injection amount Pd = Pi from the displayed one or more candidate liquid injection amounts Pi according to the patient's physical condition, schedule, etc. And decide. The processor 112 (setting unit 1122) sets the determined injection volume Pd = Pi as an initial setting value of the current injection volume, and subtracts the injection volume Pd from the standard volume S of the injection bag 52. The liquid adjustment amount is obtained, and these values are stored in a recording file in the hard disk drive 130 or the memory 114. Thereafter, the procedure exits the routine of FIG.

  For example, s = 11 choices of the allowable range of injection volume per time are (R1, R2,..., R11) = (1000 g, 1100 g,..., 2000 g) at intervals of 100 g. It is assumed that the minimum liquid injection amount Pm = 1500 g. In this case, the candidate injection amount Pi is six values Pi = (1500 g, 1600 g,... 2000 g).

  FIG. 11 illustrates an example of a screen that is displayed by the information processing apparatus 10 and displays a plurality of s = 11 candidate liquid injection amounts.

  In FIG. 11, the screen shows the current dialysis concentration (1.0 or 1.5), options (R1, R2,... R11) of a plurality of candidate liquid injection amounts of 1000 g to 2000 g, the previous liquid injection information, And records of past infusion results. Among a plurality of candidate liquid injection amounts Pi, for example, 1000 g to 2000 g, candidate liquid injection amounts Pi (for example, 1000 to 1300 g) smaller than the current minimum liquid injection amount Pm (for example, 1400 g) are not displayed. Good.

  FIG. 12 shows an example of specific processing in step 440 of FIG. This process in particular smooths the periodic measurements received from the weigh scale 40 and is based on the change in the weight of the waste bag 54 from the last period of the waste discharge stage to the last period of the injection adjustment stage. Thus, it is easy to determine the timing of the end of waste liquid discharge, the start of liquid injection adjustment, and the end of liquid injection adjustment or the start of liquid supply.

  Referring to FIG. 12, in step 502, the processor 102 (filtering unit 1130) determines whether the current state is “Waste Discharge” and the elapsed time is shorter than the shortest waste liquid discharge time (elapsed time <shortest waste liquid discharge time). Determine if. If it is determined that the state is “Waste Discharged” and the elapsed time is shorter than the shortest waste liquid discharge time, the procedure exits the routine of FIG. In this case, the period during which the end of waste liquid discharge can be determined has not been reached. If it is determined that the status is not “Waste Discharged” or the elapsed time is not shorter than the shortest waste liquid discharge time, the procedure proceeds to Step 510. In this case, the current state has reached a period in which the end of the waste liquid discharge can be determined.

  In step 510, the processor 102 (filtering unit 1130) smoothes a plurality of weight measurement values that are temporally continuous. For this purpose, for example, the median value in the measurement values during the last p seconds (for example, p = 5 seconds) is determined as the correction value of the measurement value at the point before q seconds (for example, q = 2 seconds). Also good. As a result, it is possible to suppress insignificant small fluctuations and vibrations of the weight derived from the disturbance of the waste liquid discharge flow through the branch tube 50 and the movement of the patient. The correction value may be used as a weight measurement in subsequent steps 512, 518, 524, and in steps 450 and 460 of FIG.

  In step 512, the processor 102 (filtering unit 1130) obtains the sum of absolute values of the respective fluctuation ranges between two adjacent measurement values (correction values) in the plurality of measurement values for the latest p seconds. For example, when the measurement value for p seconds is a value at intervals of 1 second, the sum of the absolute values of p fluctuation ranges is obtained. The processor 102 (filtering unit 1130) determines whether or not the sum of absolute values of the fluctuation range is smaller than a flow rate fluctuation threshold value (for example, 2g) (total absolute value of fluctuation ranges of measurement values <flow rate fluctuation threshold value). Here, the flow rate fluctuation threshold value is used to determine whether or not the change in the measured value is almost 0 (zero) and the discharge of the waste liquid is completed. If it is determined that the sum is smaller than the threshold, the procedure proceeds to step 514. If it is determined that the sum is not less than or greater than the threshold, the procedure proceeds to step 516.

  In step 514, the processor 102 (filtering unit 1130) counts up or increments (increments) the waste liquid discharge end counter used to determine the end state of the waste liquid discharge stage. In step 516, the processor 102 (filtering unit 1130) initializes a waste liquid discharge end counter to 0 (zero). When the value of the waste liquid discharge end counter is equal to or greater than the waste liquid discharge end threshold (for example, the value 18 in FIG. 7), it may be possible to determine “end of waste liquid discharge”. Thereby, in the determination of “end of waste liquid discharge”, an excessive increase and fluctuation in weight due to the movement of the patient or the like can be excluded.

  In step 518, the processor 102 (filtering unit 1130) determines whether or not the fluctuation range between the previous measurement value (correction value) and the latest (current) measurement value (correction value) is greater than a flow rate fluctuation threshold (for example, 2 g). judge. Here, the flow rate fluctuation threshold value is used to confirm or determine whether or not the change in the measured value continues to gradually increase to indicate the start state of the liquid injection adjustment stage. If it is determined that the fluctuation range is larger than the threshold value, the procedure proceeds to step 520. If it is determined that the fluctuation range is not greater than or less than the threshold value, the procedure proceeds to step 522.

  In step 520, the processor 102 (filtering unit 1130) counts up or increments (increments) the adjustment start counter used to determine the start state of the liquid injection adjustment phase by one. In step 522, the processor 102 (filtering unit 1130) initializes the adjustment start counter to 0 (zero). When the value of the adjustment start counter is equal to or greater than the adjustment start threshold (for example, the value 6 in FIG. 7), “liquid injection adjustment start” may be confirmed or determined. As a result, in the confirmation or determination of “infusion adjustment start”, it is possible to exclude an insufficient increase in weight due to patient movement or the like.

  In step 524, the processor 102 (filtering unit 1130) determines whether the absolute value of the previous measurement value and the latest (current) measurement value is greater than a flow rate variation threshold (for example, 2 g). Here, the flow rate fluctuation threshold value is used to confirm or determine whether or not the change in the measured value is almost 0 (zero), indicating the end state of the liquid injection adjustment stage. If it is determined that the absolute value is smaller than the threshold value, the procedure proceeds to step 526. If it is determined that the absolute value is not less than or greater than the threshold, the procedure proceeds to step 528.

  In step 526, the processor 102 (filtering unit 1130) increments or increments (increments) the adjustment end counter used to determine the end state of the liquid injection adjustment stage. In step 528, the processor 102 (filtering unit 1130) initializes the adjustment end counter to 0 (zero). When the value of the adjustment end counter is equal to or higher than the liquid supply start threshold value or the adjustment interruption threshold value (for example, 20), “end of liquid injection adjustment” may be confirmed or determined. Thereby, in the confirmation or determination of “end of liquid injection adjustment”, it is possible to exclude fluctuations and vibrations of excessive increase / decrease in weight resulting from the patient's movement or the like.

  By such processing of FIG. 12, it is possible to prevent erroneous state determination and perform appropriate state determination in determination and confirmation of each state in both stages of waste liquid discharge and liquid injection adjustment.

  13A and 13B show an example of specific processing in step 450 (state determination control) of FIG. In particular, this processing is performed based on the change in the weight of the waste liquid bag 54 during the period from the start of the discharge of the waste liquid to the time of the supply of the liquid injection. This is for determining the timing of “start of supplying liquid”. In addition, this process is especially effective during the period from the start of waste liquid discharge to the time of liquid supply. “Waste liquid discharge start”, “Waste liquid discharge end”, “Liquid liquid adjustment in progress”, “Liquid liquid adjustment end” and “Liquid liquid supply” This is for generating a control signal for the clamp control circuit 20 for opening / closing control of the clamps 22, 23, 24 based on the determination of “start”.

  Referring to FIG. 13A, in step 542, the processor 102 (state determination control unit 1132) determines the current state based on the initial state, previous state, or state determination result by the patient's operation on the information processing apparatus 10. Determine the state. The determined states are, for example, “initial”, “preparation complete”, “waste liquid discharge start”, “waste liquid discharge in progress”, “waste liquid discharge end”, “liquid injection adjustment in progress”, “liquid injection adjustment end” and “ It may be “injection of liquid supply”. 13A and 13B may not be executed during the period when the liquid supply is in progress after the start of liquid supply, and only steps 432, 434, and 460 in FIG. 5 may be repeatedly executed.

  If it is determined in step 542 that the current state is the “initial” state, in step 552, the processor 102 (state determination control unit 1132) sets the next current state to “ready”. Up to this point, all the clamps 22, 23 and 24 of the branch tube 50 are kept open.

  When it is determined in step 542 that the current state is “ready”, in step 554, the processor 102 (state determination control unit 1132) sets the next current state to “start waste liquid discharge”. The processor 102 (state determination control unit 1132) further supplies a control signal to the clamp control circuit 20 to maintain the clamp 22 on the liquid injection bag 52 side closed, and the clamp 23 on the catheter tube 56 side. Control is performed so that the clamp 24 on the drainage bag 54 side is in an open state. Thereby, drainage of the waste liquid from the abdominal cavity of the patient is started. The processor 102 (state determination control unit 1132) further records the measured value of the waste liquid discharge start time and the weight of the drain bag 54 at the start of the waste liquid discharge in the recording file of the hard disk drive 130 or the memory 114. The weight of the drainage bag 54 at the start of waste liquid discharge may be an empty tare weight.

  When it is determined in step 542 that the current state is “start of waste liquid discharge”, in step 556, the processor 102 (state determination control unit 1132) sets the next current state as “currently discharging waste liquid”.

  When it is determined in step 542 that the current state is “Waste Discharged”, in Step 558, the processor 102 (state determination control unit 1132) determines that the measured value of the weight of the drain bag 54 is being discharged. Determine if it shows a significant fluctuation or increase above the flow fluctuation threshold. The flow rate fluctuation threshold may be 2 g, for example. However, this determination is performed in the time period after the shortest waste liquid discharge time has elapsed. Before the shortest waste liquid discharge time elapses, it may be determined that there is a significant fluctuation or increase regardless of the measurement value. The shortest waste liquid discharge time may be, for example, 10 minutes in FIG.

  When the waste liquid discharge counter of FIG. 12 does not reach the waste liquid discharge end threshold, it may be determined that the measured value indicates a significant fluctuation. In addition, when the waste liquid discharge counter in FIG. 12 shows a value equal to or greater than the waste liquid discharge end threshold, it may be determined that the measured value does not show a significant fluctuation. The waste liquid discharge end threshold value may be, for example, 18 seconds in FIG.

  If it is determined in step 558 that the measurement indicates significant variation, the procedure exits the routine of FIGS. 13A and 13B. If it is determined in step 558 that the measured value does not indicate significant variation, the procedure proceeds to step 560. That the measured value does not show a significant fluctuation indicates that the waste liquid discharge has ended.

  In step 560, the processor 102 (state determination control unit 1132) sets the next current state as “end of waste liquid discharge”. The processor 102 (state determination control unit 1132) further supplies a control signal to the clamp control circuit 20, closes the clamp 23 on the catheter tube 56 side, and opens the clamp 22 on the injection bag 52 side. In this state, the clamp 24 on the drain bag 54 side is controlled to be opened. Thereby, the discharge of the waste liquid is completed, and the liquid injection adjustment is started.

  In step 560, the processor 102 (state determination control unit 1132) further calculates the waste liquid discharge end time and the waste liquid amount at the end of the waste liquid discharge, and the amount of water removed from the patient, and records the recorded file in the hard disk drive 130 or the memory 114. To record. The amount of waste liquid is a value obtained by subtracting the weight of the drainage bag 54 at the start of the first waste liquid discharge from the weight of the drainage bag 54 at the end of the waste liquid (weight at the end of waste liquid discharge-weight at the start of waste liquid discharge). The water removal amount is a value obtained by subtracting the previous liquid injection amount from the current liquid waste amount (waste liquid amount−previous liquid injection amount). Thereafter, the procedure exits the routine of FIGS. 13A and 13B.

  If it is determined in step 542 that the current state is “end of waste liquid discharge”, in step 562, the processor 102 (state determination control unit 1132) indicates that the measured value of the weight of the drain bag 54 is being adjusted for liquid injection. Is determined to indicate a significant increase or variation greater than the flow rate variation threshold.

  When the adjustment start counter in FIG. 12 indicates a value equal to or greater than the adjustment start threshold, it may be determined that the measured value indicates a significant increase. Moreover, when the waste liquid discharge counter of FIG. 12 does not reach the adjustment start threshold value, it may be determined that the measured value does not indicate a significant increase. The adjustment start threshold value may be, for example, 6 seconds in FIG. The fact that the measured value shows a significant increase indicates that the discharge amount from the injection bag 52 for adjusting the injection amount to the waste solution bag 54 has risen continuously, and the injection adjustment has started. . That the measured value does not show a significant increase indicates that the discharge amount from the liquid injection bag 52 to the waste liquid bag 54 does not continuously increase, and liquid injection adjustment has not yet started.

  If it is determined in step 562 that the measurement does not indicate a significant increase, the procedure exits the routine of FIGS. 13A and 13B. If it is determined in step 562 that the measured value indicates a significant increase, the procedure proceeds to step 564.

  In step 564, the processor 102 (state determination control unit 1132) sets the next current state as “injection adjustment”. Further, the processor 102 (state determination control unit 1132) obtains or calculates again the waste liquid discharge end time, the waste liquid amount, and the patient's water removal amount based on a series of records of the measurement values corrected in step 440 of FIG. To do. The processor 102 (state determination control unit 1132) records the obtained waste liquid discharge end time, the waste liquid amount and the water removal amount, and the weight of the waste liquid bag 54 at the start of the liquid injection adjustment in the recording file of the hard disk drive 130 or the memory 114. To record. Thereby, the reliability of the waste liquid discharge end time, the waste liquid amount, and the water removal amount is increased. Thereafter, the procedure exits the routine of FIGS. 13A and 13B.

  Referring to FIG. 13B, when it is determined in step 542 that the current state is “injection adjustment”, in step 570, the processor 102 (state determination control unit 1132) It is determined whether or not the current remaining amount is 0 (zero) or less, or whether or not the discharge adjustment amount has been completed. The remaining amount of the current injection adjustment amount is a value obtained by subtracting the difference between the current measurement value of the weight of the waste liquid bag 54 and the measurement value at the start of injection adjustment from the planned injection adjustment amount (scheduled injection adjustment). Adjustment amount-(current measured value-measured value at the start of injection adjustment)).

  If it is determined in step 542 that the current remaining amount of the liquid injection adjustment amount is not less than 0 or a positive value, or the discharge of the liquid injection adjustment amount is not completed, the procedure is as shown in FIGS. 13A and 13B. Exit the routine. If it is determined in step 542 that the current remaining amount of the liquid injection adjustment amount is 0 (zero) or less (or 0 or a negative value), or the discharge of the liquid injection adjustment amount is completed, the procedure is step Proceed to 572.

  In step 572, the processor 102 (state determination control unit 1132) sets the next current state as “end of liquid injection adjustment”. The processor 102 (state determination control unit 1132) further supplies a control signal to the clamp control circuit 20, closes the clamp 24 on the drainage bag 54 side, and opens the clamp 23 on the catheter tube 56 side. Then, control is performed to maintain the state in which the clamp 22 on the liquid injection bag 52 side is opened. Thereby, the adjustment of the injection amount is completed. Thereafter, the procedure exits the routine of FIGS. 13A and 13B.

  When it is determined in step 542 that the current state is “end of liquid injection adjustment”, in step 574, the processor 102 (state determination control unit 1132) sets the next current state as “liquid supply start”. To do. The processor 102 (state determination control unit 1132) further determines the current injection amount Pd from the standard amount S of the injection bag 52, the current measurement value of the weight of the waste solution bag 54, and the measurement value at the start of injection adjustment. (Pd = standard amount S− (current measurement value−measurement value at the start of injection adjustment)). The processor 102 (state determination control unit 1132) records the liquid supply start time and the current liquid injection amount Pd in the recording file of the hard disk drive 130 or the memory 114. Thereafter, the procedure exits the routine of FIGS. 13A and 13B.

  If it is determined in step 542 that the current state is “injection supply start”, in step 576, the processor 102 (state determination control unit 1132) sets the next state as “injection supply”. Thereafter, the procedure exits the routine of FIGS. 13A and 13B.

  If it is determined in step 542 that the current state is “injecting liquid supply” and other states, the procedure exits the routine of FIGS. 13A and 13B.

  After the processing of FIGS. 13A and 13B, in step 460 of FIG. 5, the previous liquid supply start time, the current waste liquid discharge start time, the dialysis time represented by the difference between these two times, the amount of waste liquid, and the liquid injection Information such as the amount, water removal amount, waste liquid discharge time, adjustment amount, and the like is displayed on the display device 122.

  Thereafter, after the supply of the liquid injection from the liquid injection bag 52 to the catheter tube 56 is completed, the user removes the empty liquid injection bag 52, removes the branch tube 50 from the connection end of the catheter tube 56, Attach a cap to the end to complete the dialysate exchange.

In this way, the process of FIGS. 13A and 13B assists in determining and adjusting the injection volume Td of the patient's each dialysate so as to satisfy the minimum injection volume T _min for one day, and the waste liquid. The opening / closing operation of the clamp for dialysate exchange according to the different weights of the bag and the corresponding states can be supported.

  FIG. 14 shows an example of a monitoring screen displayed by the information processing apparatus 10 when the state is liquid injection adjustment. On the screen, for example, “Ready”, “Waste liquid discharge start”, “Waste liquid discharge in progress”, “Waste liquid discharge end”, “Liquid liquid adjustment in progress”, “Liquid liquid adjustment end”, “Note” in FIGS. One of the states of “Liquid supply start” and “Injecting liquid supply” may be displayed.

  In the screen of FIG. 14, the current state, the current weight of the waste liquid bag 54, the previous injection start time, the current discharge start time, the dialysis time from the start of the previous supply supply to the start of the discharge of the current discharge, Waste liquid amount, previous liquid injection amount, current water removal amount, current waste liquid discharge time, current target adjustment amount, and the like are displayed. In the screen of FIG. 14, the change in the weight of the waste liquid in the waste liquid bag 54 up to the present and the remaining liquid injection amount in the liquid injection bag 52 may be displayed in the form of a bar graph.

  FIG. 15 shows an example of data in a recording file related to the patient's injection volume. The recording file may include, for example, the date, total liquid injection amount (g), each liquid supply start time, each liquid injection amount (g), and the like.

  A record as shown in FIG. 15 is stored on a medical database for a hospital, clinic, etc., even if it is printed out on paper by the printer 70 or transmitted to the server device 80 via the network 5. May be.

According to the embodiment, it is possible to assist in determining and adjusting the dialysate injection volume so that the patient's dialysate injection volume meets the minimum daily dose, and to clamp the dialysate exchange Supports operation and saves each dialysis record .

  All examples and conditional expressions given here are intended to help the reader understand the inventions and concepts that have contributed to the promotion of technology, such examples and It is understood that the present invention is not limited to the conditions, and that the organization of such examples in the specification is not related to the superiority or inferiority of the present invention. Although embodiments of the present invention have been described in detail, it will be understood that various changes, substitutions and variations can be made thereto without departing from the spirit and scope of the invention.

Regarding the embodiment including the above examples, the following additional notes are further disclosed.
(Supplementary note 1) The number of daily dialysate exchanges N of the subject stored in the storage device, the minimum total liquid injection volume T _min per day, the allowable range of liquid injection volume per time, the previous day and / or the current day Based on the past liquid injection volume and the scheduled liquid injection volume on the current day, the m-th minimum liquid injection volume Pm in continuous N dialysate exchanges (where N is a natural number, 1 ≦ m ≦ N) In this case, the total Tr of the latest (m-1) injection volume in the past and the planned injection volume for the next (N-m) and subsequent times is calculated, and the minimum total injection volume _Tmin A value obtained by subtracting the total Tr from (T _min -Tr) is determined as the minimum injection amount Pm of the m-th time,
A program for causing an information processing apparatus to execute a process of presenting a plurality of liquid injection amounts Pi that are equal to or greater than the minimum liquid injection amount Pm within the allowable range of the liquid injection amount per time as options for the m-th liquid injection amount.
(Supplementary Note 2) Based on the standard amount S of the liquid injection bag and the m-th liquid injection amount Pd selected by the user, the increase amount D of the weight of the waste liquid bag discharged from the liquid injection bag to the waste liquid bag Stops being discharged into the waste liquid bag when the difference between the standard amount S and the selected injection amount Pd or larger (D ≧ S−Pd), and then the injection A control command for opening and closing a flow path between the injection bag, the waste solution bag, and a tube coupled to the subject's peritoneum so as to start supply of injection from the solution bag to the subject's peritoneum. The program according to appendix 1, which causes the information processing apparatus to execute processing to be generated.
(Additional remark 3) The increase amount per unit time of the weight of the said waste liquid bag discharged | emitted from the tube couple | bonded with the said test subject's peritoneum to the said waste liquid bag represented by the detected amount of the said waste liquid bag became smaller than the threshold value A tube coupled to the injection bag, the waste bag and the subject's peritoneum to stop discharging into the waste bag and then start discharging from the injection bag to the waste bag The program according to appendix 2, which causes the information processing apparatus to execute processing for generating a control command for opening and closing a flow path between the two.
(Supplementary note 4) N daily dialysate exchange number of subject, minimum daily total injection volume T _min , permissible range of injection volume per injection, previous day and / or previous injection volume of each day , And a storage device for storing the amount of liquid to be injected each time,
Number N of dialysate exchanges per day, minimum total liquid injection amount T _min per day, permissible range of the liquid injection amount per time, liquid injection volume for each past, and planned liquid injection for each time Based on the volume, the minimum injection volume Pm of the m-th in continuous N dialysate exchanges is obtained (where N is a natural number, 1 ≦ m ≦ N), and the latest latest (m−1) The total Tr of the injection volume for the next batch and the planned injection volume for the next (N−m) and subsequent times is obtained, and the value obtained by subtracting the total Tr from the minimum total injection volume T _min (T _min −Tr) a calculation unit to obtain the m-th minimum injection amount Pm;
A presenting unit that presents a plurality of liquid injection amounts Pi that are equal to or greater than the lowest liquid injection amount Pm within the allowable range of the liquid injection amount per time, as options for the m-th liquid injection amount;
An information processing apparatus including:
(Supplementary Note 5) Based on the standard amount S of the injection bag and the m-th injection amount Pd selected by the user, the increase amount D of the weight of the waste bag discharged from the injection bag to the waste bag Stops discharging into the waste bag when the difference between the standard amount S and the selected injection amount Pd is greater than or equal to, and then from the injection bag to the subject's peritoneum Including a control unit for generating a control command for opening and closing a flow path between the liquid injection bag, the waste liquid bag, and a tube coupled to the peritoneum of the subject so as to start supply of liquid injection to The information processing apparatus according to appendix 4.
(Additional remark 6) The said control part is the increase amount per unit time of the weight of the said waste liquid bag discharged | emitted from the tube couple | bonded with the test subject's peritoneum to the said waste liquid bag represented by the detected amount of the said waste liquid bag. The liquid injection bag, the liquid waste bag, and the peritoneum of the subject so as to stop discharge to the liquid waste bag when it becomes smaller than the threshold and then start discharge from the liquid injection bag to the liquid waste bag The information processing apparatus according to appendix 5, which generates a control command for opening and closing a flow path between tubes coupled to.

DESCRIPTION OF SYMBOLS 5 Network 10 Information processing apparatus 112 Processor 114 Memory 130 Hard disk drive 20 Clamp control circuit 22, 23, 24 Clamp 30 Weight measuring circuit 40 Weigh scale 50 Branching tube 52 Injection bag 54 Waste solution bag 56 Catheter tube

Claims (4)

The number of dialysate exchanges per day N of the subject stored in the storage device, the minimum total infusion volume T _min per day, the permissible range of infusion volume per time, the previous day and / or the past each day Based on the injection volume and the scheduled injection volume for each day of the day, the mth minimum injection volume Pm ( where N is a natural number, 1 ≦ m ≦ N) in continuous N dialysate exchanges, At that time, to find the total Tr of the past of the latest of (m-1) times of the pouring amount and the next and subsequent (N-m) times of scheduled pouring amount, the total from the total liquid injection amount T _min of the lowest Tr Is obtained as the minimum injection amount Pm of the m-th time,
A program for causing an information processing apparatus to execute a process of presenting a plurality of liquid injection amounts Pi that are equal to or greater than the minimum liquid injection amount Pm within the allowable range of the liquid injection amount per time as options for the m-th liquid injection amount. Standard amount S of pouring bag, and on the basis of the selected m-th pouring amount Pd by the user, the amount of increase in the weight of the waste bag that is discharged to the pouring bag or we waste liquid bag, the standard When the difference between the amount S and the selected injection amount Pd is greater than or equal to, the discharge to the waste bag is stopped, and then the injection from the injection bag to the peritoneum of the subject To cause the information processing apparatus to execute a process for generating a control command for opening and closing a flow path between the liquid injection bag, the waste liquid bag, and a tube coupled to the peritoneum of the subject. The program according to claim 1.   When the increase amount per unit time of the weight of the waste bag discharged from the tube coupled to the peritoneum of the subject represented by the detected amount of the waste bag is smaller than a threshold value, The flow between the injection bag, the waste bag and the tube connected to the peritoneum of the subject so as to stop discharging to the waste bag and then start discharging from the injection bag to the waste bag. The program according to claim 2, which causes the information processing apparatus to execute processing for generating a control command for opening and closing a road. Number of N dialysate exchanges per day for subject, minimum daily total injection volume T _min , allowable range of injection volume per injection, previous day and / or each previous injection volume of the day, and current day A storage device for storing the amount of liquid to be injected each time;
Number N of dialysate exchanges per day, minimum total liquid injection amount T _min per day, permissible range of the liquid injection amount per time, liquid injection volume for each past, and planned liquid injection for each time Based on the volume, the m-th minimum injection volume Pm ( where N is a natural number, 1 ≦ m ≦ N) in N consecutive dialysate exchanges is determined, and the latest latest (m−1) The total Tr of the injection volume for the next batch and the planned injection volume for the next (N−m) and subsequent times is obtained, and the value obtained by subtracting the total Tr from the minimum total injection volume T _min is the minimum injection volume for the mth time. A calculation unit for obtaining the liquid amount Pm;
A presenting unit that presents a plurality of liquid injection amounts Pi that are equal to or greater than the lowest liquid injection amount Pm within the allowable range of the liquid injection amount per time, as options for the m-th liquid injection amount;
An information processing apparatus including:

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