JP6795966B2 - Dialysis system - Google Patents

Description

The present invention relates to a dialysis system and is suitable for removing waste products in blood.

As a dialysis system that removes waste products in the blood and purifies the blood, there are a dialysis system using a personal dialysis machine (preparing dialysate for each unit) and a dialysis system called a central dialysate supply system.

A dialysis system using a personal dialysis machine purifies blood by a personal dialysis machine assigned to the dialysis patient using a liquid dialysis agent contained in a large plastic container suitable for one dialysis patient. It has become like. For this reason, a dialysis system using a personal dialysis machine can use different dialysates for each dialysis patient, but it requires a lot of space for storing the dialysis solution in a large plastic container, and is used for dialysis. There is a problem that transportation when using the drug for treatment requires an excessive burden on the medical staff.

On the other hand, in the central dialysate supply system, a concentrated solution is prepared by a dialysate dissolving device based on a small volume and lightweight powdered dialysate, and the concentrated solution is used as a basis for a multi-person dialysate supply device. To prepare a dialysate whose concentration has been adjusted by. In addition, a dialysate whose concentration has been adjusted is supplied to each dialysis apparatus, and the supplied dialysate purifies the blood of each dialysis patient. For this reason, in the central dialysate supply system, the volume of the dialysate is small and the weight is reduced, so that the storage of the dialysate does not require a place, and the medical staff is engaged in medical treatment by transporting the dialysate when it is used for treatment. The problem of demanding an excessive burden on the person is solved.

As such a central dialysate supply system, for example, the dialysate system of Patent Document 1 below is disclosed. In the dialysis system of Patent Document 1, an acidic concentrate supply means for supplying an acidic concentrate, a basic concentrate supply means for supplying a basic concentrate, an RO device for supplying RO water, and a dialysate for a large number of people. It is equipped with a supply device and a personal dialysis machine.

The multi-person dialysate supply device is connected to the acidic concentrate supply means, the basic concentrate supply means, and the RO device, respectively, and the acidic concentrate and the basic concentrate are diluted with RO water to prepare the dialysate. Create and supply this to a personal dialysis machine.

The personal dialysis machine is connected to the acidic concentrate supply means and the basic concentrate supply means, and is also connected to the multi-person dialysate supply device and the RO device via the flow path switching means. The structure is such that the flow path from the dialysate supply device for multiple people and the RO device can be switched selectively.

According to the dialysis system of Patent Document 1 below, for a personal dialysis machine used by a patient who requires prescription dialysis, a flow path is provided from a multi-person dialysate supply device to an RO device by means of a flow path switching means. The dialysate can be switched to use a dialysate prepared at a mixing ratio suitable for the patient.

JP-A-2009-279110

However, the dialysis system of Patent Document 1 does not solve the problem that, for patients who require prescription dialysis, the medical staff is required to bear an excessive burden by transporting the dialysis agent when it is used for treatment. In addition, every time dialysis treatment is performed on a patient who requires prescription dialysis, it is necessary to prepare a dialysate prepared with a prescription suitable for the patient, and there is a problem that the preparation also imposes an excessive burden on medical staff. .. If such an excessive burden is required, there is concern that it may cause a medical accident.

Therefore, the present invention proposes a dialysis system that can reduce the burden on medical staff.

The present invention is a dialysis system, in which a dialysis device, which is a powdered dialysis agent, is dissolved in RO water to prepare a concentrated solution, and a dialysate obtained from the concentrated solution is used for blood. It is provided with a transfer device capable of self-propelling to a dialysis device for purifying the dialysis device, and a controller for controlling the dissolution device and the transfer device. The controller controls the dissolution device to tank a concentrated liquid for a dialysis patient. The adjusted concentrate should be transferred from the tank to a container arranged in the transfer device and moved to the location of the dialysis device assigned to the dialysis patient with respect to the transfer device. It is characterized by giving a command.

In the present invention, since the concentrated liquid can be obtained by using the dissolving device, the burden on the medical staff who prepares the concentrated liquid can be reduced. Further, in the present invention, the concentrated liquid is transferred from the tank to the container arranged in the transfer device by using the dissolving device, and the container containing the concentrated liquid is transferred to the place of the dialysis device by the transfer device. Therefore, it is possible to reduce the burden on the medical staff who transports the powdered dialysis agent and the concentrated liquid. In this way, a dialysis system that can reduce the burden on the medical staff is provided. In addition, even though it is a central dialysate supply system, it is possible to receive optimal dialysis treatment by each dialysis patient.

It is a figure which shows the outline of the structure of the dialysis system. It is a figure which shows the outline of the structure of the concentrated liquid supply unit. It is a figure which shows the outline of the work area of a robot arm. It is a figure which shows the outline of the composition in a drug selection area. It is a figure which shows the outline of the structure in the drug mixing area. It is a figure which shows the outline of the structure in the transfer area. It is a figure which shows the outline of the structure of a controller. It is a figure which shows an example of a database. It is a flowchart which shows the concentrated liquid supply method. It is a figure which shows the outline of the structure of the concentrated liquid supply unit in 2nd Embodiment. It is a figure which shows the outline of the structure in the drug selection area in 2nd Embodiment. It is a figure which shows the example which is displayed in the used drug of a database when the used drug is prescribed.

Hereinafter, embodiments for carrying out the present invention and modifications thereof will be illustrated together with the accompanying drawings. The embodiments illustrated below and examples thereof are intended to facilitate understanding of the present invention, and are not intended to limit the interpretation of the present invention. The present invention can be modified and improved without departing from the spirit of the present invention.

(1) First Embodiment << Overall configuration of dialysis system >>
FIG. 1 is a diagram showing an outline of the configuration of a dialysis system. As shown in FIG. 1, the dialysis system 1 of the present embodiment is a central dialysate supply system, and is composed of an RO device 2, a concentrated liquid supply unit 3, and a plurality of dialysis devices 4A to 4F.

The RO device 2 prepares RO water using an RO (Reverse Osmosis) membrane, and supplies the RO water to the concentrated liquid supply unit 3 and the plurality of dialysis devices 4A to 4F, respectively. In the case of the present embodiment, the RO device 2 is installed in a room different from the dialysis devices 4A to 4F installed in the dialysis room, which is a room for performing dialysis treatment, for example.

The concentrated liquid supply unit 3 holds patient information as a database, which is information about dialysis patients using the dialysis devices 4A, 4B ... Or 4F. In the case of the present embodiment, the concentrated liquid supply unit 3 is installed in the same room as the RO device 2, for example.

Based on the database, the concentrated liquid supply unit 3 includes a powder dialysis agent, which is a powdered dialysis agent for each dialysis patient using the dialysis devices 4A to 4F, and an RO supplied from the RO device 2. Make a concentrated solution with water. The concentrated solution is prepared before a predetermined time of the dialysis treatment time of the dialysis patient. Further, when the concentrated liquid is prepared, the concentrated liquid supply unit 3 supplies the concentrated liquid to the dialysis devices 4A, 4B ... Or 4F used by the dialysis patient corresponding to the concentrated liquid based on the database. In the present embodiment, a pair of agent A and agent B is adopted as the powder dialysis agent, and as the concentrate, an acidic concentrate obtained from agent A and RO water and a basic concentrate obtained from agent B and RO water are used. Is adopted.

The dialysis device 4A is a general term for devices that purify blood using a dialysate obtained from a concentrated solution. For example, a versatile dialysis machine, a personal dialysis machine, or a dialysis machine that puts blood outside the body. It is said to be a medical device used to return blood purified by the dialyzer to the body. The multipurpose dialysis machine includes a personal dialysis machine that purifies blood using a dialysis solution for one dialysis patient and a device that controls applications other than dialysis, such as adjusting the concentration of the dialysate. It has. In such a dialysis apparatus 4A, a blood circuit connected to a shunt of a dialysis patient, a dialyzer provided at a predetermined portion of the blood circuit, a dialysis circuit connected to the dialyzer, and a dialysis circuit connected to the dialyzer. It includes a dialysate generator.

An acidic concentrated liquid and a basic concentrated liquid are individually supplied from the concentrated liquid supply unit 3 to the dialysate generating unit of the dialysis apparatus 4A, and the acidic concentrated liquid, the basic concentrated liquid, and RO water are mixed in the dialysate generating unit. A dialysate is produced by this. In the dialyzer of the dialysis apparatus 4A, the blood supplied from the shunt of the dialysis patient via the blood circuit and the dialysate supplied from the dialysate generator via the dialysis circuit are flowed across the semipermeable membrane. As a result, the dialyzer removes waste products in the blood taken from the dialysis patient and replenishes the necessary electrolyte, and the resulting blood is returned from the shunt to the dialysis patient via the blood circuit from the dialyzer. In addition, examples of waste products include uremic substances containing urea nitrogen, creatinine and urea.

The dialysis devices 4B to 4F have the same configuration as the dialysis device 4A. In each dialysis device 4B to 4F, similarly to the dialysis device 4A, waste products in the blood taken out from the dialysis patient are removed and necessary electrolytes are replenished, and the resulting blood is transferred from the dialyzer to the blood circuit. Returned from the shunt to the dialysis patient via.

<Structure of concentrated liquid supply unit>
FIG. 2 is a diagram showing an outline of the configuration of the concentrated liquid supply unit. As shown in FIG. 2, the concentrated liquid supply unit 3 has a robot arm 10 and a controller 20.

The robot arm 10 is an arm-shaped robot that can grip and move an object, and is one of the components of a dissolving device that dissolves a powder dialysis agent in RO water to adjust a concentrated liquid. The robot arm 10 of the present embodiment includes a pedestal 11, a plurality of arm pieces 12A to 12C, a grip portion 13, and a camera 14 as main components. The pedestal 11 supports a plurality of arm pieces 12A to 12C.

Of the plurality of arm pieces 12A to 12C, the arm piece 12A on the root side is rotatably attached to the pedestal 11 via the yaw axis and rotatably via the pitch axis. The plurality of arm pieces 12A to 12C are rotatably connected to each other via a yaw axis.

The grip portion 13 is capable of holding an object so as to sandwich a pair of grip pieces. Further, the grip portion 13 is rotatably attached to the arm piece 12C on the tip end side of the plurality of arm pieces 12A to 12C via the yaw axis and rotatably via the pitch axis.

The camera 14 is provided at a predetermined portion of the grip portion 13. The camera 14 generates image data showing an image of a position separated from the grip portion 13 by a predetermined distance, and sends the image data to the controller 20.

In the case of the present embodiment, as shown in FIG. 3, as a working area of the robot arm 10, a drug selection area AR1, a drug mixing area AR2, a dissolution area AR3, a transfer area AR4, and a disposal area AR5 are provided around the robot arm 10. It is provided.

The drug selection area AR1 is a work area for selecting a powder dialysis agent to be used for a dialysis patient to be treated with dialysis from a plurality of types of powder dialysis agents. For example, a drug shelf 17 is installed in the drug selection area AR1, and a plurality of drug bottles 18 which are containers for powder dialysis agents are arranged in the drug shelf 17. In the case of the present embodiment, as shown in FIG. 4, the drug bottle 18 of the agent A, which is one of the pair of powder dialysis agents manufactured by a plurality of manufacturers, and the drug bottle 18 of the agent B, which is the other of the pair. Are each placed on the drug rack 17. An identifier such as a serial number of the manufacturer that manufactured the powder dialysis agent contained therein is attached to these drug bottles 18. This identifier is captured by the camera 14 of the robot arm 10, and the powder dialysis agent to be used for the dialysis patient is selected by the controller 20 based on the imaging result.

The drug mixing area AR2 is a work area for mixing the powder dialysis agent selected in the drug selection area AR1 and the RO water produced by the RO apparatus 2. In the case of the present embodiment, as shown in FIG. 5, a mixer 30 for mixing the powder dialysis agent and RO water is arranged in the drug mixing area AR2. The mixer 30 is one of the components of the dissolving device, and has an A agent tank 31A and a B agent tank 31B, and an A agent funnel 34A and a B agent funnel 34B. The agent A tank 31A is arranged in the holder 32A, and the agent B tank 31B is arranged in the holder 32B. The agent A tank 31A and the agent B tank 31B are connected by a connecting portion 33 that can be gripped by the gripping portion 13 of the robot arm 10. Further, the agent A tank 31A and the agent B tank 31B have inlets for charging RO water and powder dialysis agent, and the funnel 34A for agent A is arranged at the inlet of the agent A tank 31A. At the same time, a funnel 34B for agent B is arranged at the inlet of the agent B tank 31B.

The funnel 34A for agent A and the funnel 34B for agent B are connected by a connecting portion 35 that can be gripped by the gripping portion 13 of the robot arm 10, and the retracting position and the using position are connected by the robot arm 10 that grips the connecting portion 35. It is possible to move between and. Further, tubes 36A and 36B connected to the RO device 2 are attached to the funnel 34A for the agent A and the funnel 34B for the agent B. Pumps 37A and 37B are provided in the tubes 36A and 36B, and when the pumps 37A and 37B are driven, RO water is supplied to the corresponding funnels for agent A and funnel 34B for agent B.

The dissolution area AR3 is a working area for stirring the powder dialysis agent and RO water mixed in the drug mixing area AR2. In the case of the present embodiment, a stirrer (not shown), which is one of the components of the melting device, is installed in the melting area AR3. In the dissolution area AR3, the RO water and the powder dialysis agent in the agent A tank 31A and the agent B tank 31B moved from the drug mixing area AR2 by the robot arm 10 are stirred by the stirrer. As a result, the acidic concentrated liquid containing the A agent is generated in the A agent tank 31A, and the basic concentrated liquid containing the B agent is produced in the B agent tank 31B.

Instead of the stirrer, the robot arm 10 may grip the connecting portion 33 with the gripping portion 13 to stir the RO water and the powder dialysis agent in the agent A tank 31A and the agent B tank 31B. Alternatively, an oscillator may be provided in the agent A tank 31A and the agent B tank 31B, and the RO water and the powder dialysis agent in the agent A tank 31A and the agent B tank 31B may be agitated by the oscillator.

The transfer area AR4 is a work area for starting the transfer of the concentrated liquid (acidic concentrated liquid / basic concentrated liquid) obtained by stirring the powder dialysis agent and RO water in the dissolution area AR3. In the case of the present embodiment, as shown in FIG. 6, transfer devices 40A and 40B capable of self-propelling from the transfer area AR4 to the dialysis devices 4A, 4B ... Or 4F are arranged in the transfer area AR4. The transfer devices 40A and 40B include, for example, the transfer areas AR4 and the dialysis devices 4A to 4F based on the radio waves transmitted from the markers arranged at predetermined intervals on the route from the transfer area AR4 to the dialysis devices 4A to 4F. Can run on its own between. Further, for example, the transfer devices 40A and 40B can self-propell between the transfer area AR4 and the dialysis devices 4A to 4F through rails arranged on the route from the transfer area AR4 to the dialysis devices 4A to 4F. Further, for example, the transfer devices 40A and 40B can self-propell between the transfer area AR4 and the dialysis devices 4A to 4F using GPS (Global Positioning System).

The transfer device 40A is a transfer device for transferring the concentrated liquid containing the agent A, and the transfer device 40B is a transfer device for transferring the concentrated liquid containing the agent B. These transporters 40A and 40B can exchange various data with the controller 20 by, for example, wireless communication. Further, the transferors 40A and 40B have a holding container 42 for holding the concentrated liquid pack 41 in which the concentrated liquid is contained.

A tube 41A is connected to the concentrated liquid pack 41, and an opening / closing cock 41B is provided at the tip of the tube 41A. The opening / closing cock 41B can be opened / closed by the grip portion 13 of the robot arm 10. The concentrated liquid pack 41 is a container made of a soft plastic such as vinyl chloride.

Further, in the case of the present embodiment, as shown in FIG. 6, the concentrated liquid introducers 44A and 44B, which are one of the components of the dissolving apparatus, are arranged in the transfer area AR4. The concentrated liquid introducers 44A and 44B introduce the concentrated liquid into the concentrated liquid pack 41 of the corresponding transfer devices 40A and 40B.

The concentrated liquid introducers 44A and 44B are packs in which the tank-side connector portion 45 to which the A agent tank 31A and the B agent tank 31B can be detachably connected and the openable cock 41B of the concentrated liquid pack 41 can be detachably connected. It has a side connector portion 46. Even when the opening / closing cock 41B is connected to the pack-side connector portion 46, the opening / closing cock 41B can be opened / closed by the grip portion 13 of the robot arm 10. When the open / close cock 41B connected to the pack-side connector portion 46 is opened, the concentrated liquid stored in the agent A tank 31A or the agent B tank 31B connected to the tank-side connector portion 45 flows into the concentrated liquid pack 41. Will be done.

The disposal area AR5 is a work area for discarding the waste obtained in each of the work areas of the drug selection area AR1, the drug mixing area AR2, the dissolution area AR3, and the transfer area AR4. For example, a disposal stand is provided in this disposal area AR5, and used drug bottles 18 and the like are disposed of in a disposal bag attached to the disposal stand.

The melting devices (robot arm 10, mixer 30, stirrer, concentrated liquid introducer 44A, 44B) and the transfer devices 40A, 40B working in such a work area are appropriately controlled by the controller 20.

FIG. 7 is a diagram showing an outline of the configuration of the controller. The controller 20 is a computer that comprehensively controls the concentrated liquid supply unit 3, and as shown in FIG. 7, has a configuration including an input unit 21, a storage unit 22, and a control unit 23.

The input unit 21 is configured to be able to input various information such as patient information indicating information on dialysis patients as data. For example, the input unit 21 may input information based on operations by a keyboard, mouse, or the like as data, and inputs information data stored in the IC card by communicating with an IC card assigned to an individual patient. You may try to do it. The data input to the input unit 21 is given to the control unit 23.

The storage unit 22 has a first storage area for storing various programs, a second storage area for storing various data such as setting data input to the input unit 21 and data indicating patient information, and the program. And the expansion area where data is expanded. In the first storage area of the present embodiment, a concentrated liquid supply program for executing a process of supplying the concentrated liquid to the dialysis machines 4A, 4B ... Or 4F is stored. In addition, a database DB is constructed in the second storage area.

FIG. 8 is a diagram showing an example of a database. As shown in FIG. 8, in the database DB of the present embodiment, the patient ID, which is an identifier uniquely assigned to the dialysis patient for management in the hospital, and the patient information are associated with each other.

Patient information includes the name, gender, age, height, weight, dialysis schedule (treatment date and time, etc.), dialysis solution prescription (drugs used, etc.), dialysis time, dialysate flow rate, and the required dialysis solution. Includes quantity, dialysis equipment used, beds, etc. However, patient information may be adopted in addition to the examples shown in FIG. 8 or in place of the examples shown in FIG.

The dialysis execution schedule is an item indicating a schedule for performing dialysis treatment of a dialysis patient specified by a patient ID. In this dialysis execution schedule, for example, the date and time when the dialysis treatment of the dialysis patient is scheduled to be performed is displayed. In the example shown in FIG. 8, the date is omitted for convenience. As shown in FIG. 8, when there are a plurality of schedules for performing dialysis treatment, the plurality of schedules are displayed.

The drug used is an item indicating a powder dialysis drug to be used for a dialysis patient specified by a patient ID. For the drug used, for example, a dialysis agent identifier such as a brand name or a product number that identifies an existing powder dialysis agent (agent A / agent B) manufactured in advance by the manufacturer is displayed.

The bed used is an item indicating the installation location of the dialysis devices 4A, 4B ... Or 4F assigned to the dialysis patient specified by the patient ID. On the bed used, for example, position information for specifying the location of the bed on which the dialysis apparatus 4A, 4B ... Or 4F is installed is displayed. For this position information, for example, the position information by GPS is displayed.

When such patient information is input by the input unit 21, the control unit 23 registers it in the database DB. That is, when patient information is input by the input unit 21, a new patient ID is generated by the control unit 23 for the patient information, and the patient ID and the patient information are registered in the database DB by the control unit 23. Be associated with. The control unit 23 comprehensively controls the entire concentrated liquid supply unit 3 based on this database DB.

That is, for example, the control unit 23 refers to the dialysis execution schedule in the database DB every time the date changes, and if there is a plan to perform dialysis treatment on the date, the concentrate supply program is a predetermined time before the scheduled time. Is expanded in the expansion area of the storage unit 22. In this case, the control unit 23 functions as a drug selection unit 23A, a drug mixing unit 23B, a dissolving unit 23C, and a transfer unit 23D, and the dissolving devices (robot arm 10, mixer 30, stirrer, concentrated liquid introducer 44A, 44B). ) And the transfer devices 40A and 40B are appropriately controlled to execute various processes in the work area.

For example, a case where the patient ID “6” shown in FIG. 8 is scheduled to perform dialysis treatment on the day of the week 1 which is the date will be described. In this case, a concentrated liquid (acidic concentrated liquid / basic concentrated liquid) containing the dialysis agent A is supplied to, for example, the dialysis apparatus 4A assigned to the bed B-1 before the scheduled time of 9:00 am. As described above, the drug selection unit 23A, the drug mixing unit 23B, the dissolving unit 23C, and the transfer unit 23D execute each process. In the case of the patient ID “6” shown in FIG. 8, since the dialysate flow rate is 500 ml / min and the dialysate time is 4 hours, the required dialysate amount is 120 L, and the required concentrated solution amount is 3. It is said to be 5L.

The drug selection unit 23A recognizes a powder dialysis agent to be used for a dialysis patient who plans to perform dialysis treatment based on the database DB. Specifically, the drug selection unit 23A controls the robot arm 10, identifies the type of the drug bottle 18 based on the image data supplied from the camera 14 of the robot arm 10, and the A agent corresponding to the dialysis agent A. The drug bottle 18 and the drug bottle 18 of the B agent are selected from the drug shelf 17 of the drug selection area AR1.

When the weight data from the weight sensing sensor reaches the weight calculated to be contained in the concentrated liquid, the drug selection unit 23A may return the drug bottle to the drug shelf.

The drug mixing unit 23B controls the robot arm 10 to move the funnel for agent A and the funnel for agent B 34B provided in the drug mixing area AR2 from the retracted position to the used position. Then, the drug mixing unit 23B controls the robot arm 10 to grip the drug bottle 18 of the agent A selected by the drug selection unit 23A and put it into the funnel 34A for the agent A. At this time, the drug mixing unit 23B drives the pump 37A to charge a specified amount (for example, 3.5 L) of RO water into the funnel for agent A 34A. Further, the drug mixing unit 23B controls the robot arm 10 to grip the drug bottle 18 of the B agent selected by the drug selection unit 23A and put it into the funnel for the B agent 34B. At this time, the drug mixing unit 23B drives the pump 37B to charge a specified amount (for example, 3.5 L) of RO water into the funnel for agent B 34B.

In this way, the drug mixing unit 23B mixes agent A and RO water, which is one of the pair of powder dialysis agents, and mixes agent B and RO water, which is the other of the pair of powder dialysis agents. It is designed to do.

The drug mixing unit 23B controls the robot arm 10 to dispose of the drug bottle 18 whose powder dialysis agent has been emptied by adding the powder dialysis agent into the disposal bag in the disposal area AR5. .. Further, the drug mixing unit 23B moves the funnel 34A for the A agent and the funnel 34B for the B agent from the use position to the retracted position when the powder dialysis agent and the RO water are completely mixed. ..

The melting unit 23C controls the robot arm 10 to move the agent A tank 31A and the agent B tank 31B arranged in the holders 32A and 32B of the agent mixing area AR2 to the stirrer in the dissolution area AR3. Then, the melting unit 23C drives a stirrer to stir the RO water and the powder dialysis agent in the agent A tank 31A and the agent B tank 31B for a specified time. As a result, the acidic concentrated liquid containing the A agent is generated in the A agent tank 31A, and the basic concentrated liquid containing the B agent is produced in the B agent tank 31B.

The melting unit 23C is designed to stop the stirrer when the specified time has elapsed.

The transfer unit 23D controls the robot arm 10 and connects the A agent tank 31A and the B agent tank 31B arranged in the stirrer in the dissolution area AR3 to the tank side connectors of the corresponding concentrated liquid introducers 44A and 44B in the transfer area AR4. It is connected to the unit 45. Further, the transfer unit 23D controls the robot arm 10 to arrange empty concentrated liquid packs 41 in the holding containers 42 of the transfer devices 40A and 40B arranged in the transfer area AR4, respectively.

After that, the transfer unit 23D connects the opening / closing cock 41B of the concentrated liquid pack 41 arranged in the holding container 42 of the transfer device 40A to the pack-side connector portion 46 of the concentrated liquid introducer 44A, and connects the concentrated liquid pack 41 and the agent A. Communicate with tank 31A. Further, the transfer unit 23D connects the opening / closing cock 41B of the concentrated liquid pack 41 arranged in the holding container 42 of the transfer device 40B to the pack-side connector portion 46 of the concentrated liquid introducer 44B, and connects the concentrated liquid pack 41 and the B agent tank. Communicate with 31B.

When the concentrated liquid pack 41 is communicated with each of the agent A tank 31A and the agent B tank 31B, the transfer unit 23D opens the opening / closing cock 41B of the concentrated liquid pack 41. As a result, the acidic concentrated liquid flows into the concentrated liquid pack 41 of the transfer device 40A, and the basic concentrated liquid flows into the concentrated liquid pack 41 of the transfer device 40B.

When the transfer unit 23D finishes flowing the acidic concentrated liquid and the basic concentrated liquid into the corresponding concentrated liquid pack 41, the transfer unit 23D recognizes the place where the concentrated liquid pack 41 should be transferred based on the database DB. Then, the transfer unit 23D wirelessly communicates with the transfer devices 40A and 40B, and gives the transfer devices 40A and 40B the position information of the dialysis apparatus 4A and a command to move to the position indicated by the position information. .. As a result, the transfer devices 40A and 40B self-propell to the dialysis apparatus 4A, and the transfer devices 40A and 40B transport the concentrated liquid pack 41 containing the acidic concentrated liquid and the concentrated liquid pack 41 containing the basic concentrated liquid. To.

After giving the transfer units 40A and 40B a command to move to a predetermined position, the transfer unit 23D waits until the transfer units 40A and 40B receive data indicating that the transfer of the concentrated liquid pack 41 is completed. When the data is received, the database DB is updated. Specifically, for example, when the data indicating that the transfer of the concentrated liquid on the day of the week 1 of the patient ID of "6" shown in FIG. 8 is completed is received, it is displayed in the schedule column corresponding to the day of the week 1. The database DB is updated by deleting the items.

The control unit 23 functions as such a drug selection unit 23A, a drug mixing unit 23B, a dissolving unit 23C, and a transfer unit 23D, and the concentrated liquid supply process is executed.

<Concentrated liquid supply method>
FIG. 9 is a flowchart showing a concentrated liquid supply method. As shown in FIG. 9, the control unit 23 refers to the dialysis execution schedule in the database DB every time the date changes, and starts the concentrated liquid supply process when the dialysis treatment is scheduled to be performed on the date. , Proceed to drug selection step SP1.

In the drug selection step SP1, the control unit 23 recognizes agents A and B, which are powder dialysis agents to be used for dialysis patients who are planning to perform dialysis treatment, based on the database DB. Then, the control unit 23 uses the camera 14 of the robot arm 10 to select the drug bottle 18 containing the agent A and the drug bottle 18 containing the agent B from the drug rack 17, and then proceeds to the mixing step SP2. ..

In the mixing step SP2, the control unit 23 controls the robot arm 10 to put the agent A selected in the agent selection step SP1 and the RO water produced by the RO device 2 into the agent A tank 31A and mix them. Further, the control unit 23 puts the B agent selected in the agent selection step SP1 and the RO water produced by the RO device 2 into the B agent tank 31B and mixes them, and proceeds to the dissolution step SP3.

In the dissolution step SP3, the control unit 23 stirs the agent A and the RO water contained in the agent A tank 31A in the mixing step SP2 with a stirrer to generate an acidic concentrated liquid. Further, the control unit 23 stirs the B agent and RO water contained in the B agent tank 31B in the mixing step SP2 with a stirrer to generate a basic concentrated liquid, and proceeds to the transfer preparation step SP4.

In the transfer preparation step SP4, the control unit 23 controls the robot arm 10 to store the acidic concentrated liquid produced in the dissolution step SP3, the A agent tank 31A, and the basic concentrated liquid, the B agent tank 31B. To the corresponding concentrated liquid introducers 44A and 44B. Then, the control unit 23 communicates the concentrated liquid pack 41 arranged in the holding container 42 of the transfer device 40A with the A agent tank 31A through the concentrated liquid introducing device 44A, so that the acidic concentration stored in the A agent tank 31A is stored. Put the liquid in the concentrated liquid pack 41. Further, the control unit 23 communicates the concentrated liquid pack 41 arranged in the holding container 42 of the transfer device 40B with the B agent tank 31B through the concentrated liquid introducing device 44B, so that the basicity is stored in the B agent tank 31B. The concentrated liquid is put into the concentrated liquid pack 41, and the process proceeds to the transfer step SP5.

In the transfer step SP5, the control unit 23 contains a concentrated liquid pack 41 containing an acidic concentrated liquid in the transfer preparation step SP4 and a concentrated liquid pack 41 containing a basic concentrated liquid in the transfer preparation step SP4, based on the database DB. Recognize the location information to be transferred. Then, the control unit 23 gives the transfer device 40A in which the concentrated liquid pack 41 containing the acidic concentrated liquid is arranged, for example, the position information of the dialysis apparatus 4A and a command to move to the position indicated by the position information. give. Further, the control unit 23 gives the transfer device 40B in which the concentrated liquid pack 41 containing the basic concentrated liquid is arranged, for example, the position information of the dialysis apparatus 4A and a command to move to the position indicated by the position information. Is given, and the process proceeds to the standby step SP6.

In the standby step SP6, the control unit 23 waits until it receives data indicating that the transfer of the concentrated liquid pack 41 has been completed from the transfer devices 40A and 40B, and receives the data. To update step SP7.

In the update step SP7, the control unit 23 updates the database DB by deleting the items displayed in the schedule column corresponding to the date in the dialysis execution schedule in the database DB, and then performs the concentrated liquid supply process. finish.

<Summary>
As described above, in the dialysis system 1 of the present embodiment, the controller 20 uses the robot arm 10, the mixer 30, and the stirrer in the dissolving device to prepare the concentrated liquid for the dialysis patient into the A agent tank 31A and the B agent tank 31B. It is designed to be adjusted separately. Therefore, in the dialysis system 1 of the present embodiment, the work of adjusting the concentrated liquid by the medical staff is avoided, and the burden on the medical staff is reduced.

Further, in the dialysis system 1 of the present embodiment, the controller 20 uses the robot arm 10 and the concentrated liquid introducers 44A and 44B in the dissolving device to transfer the A agent tank 31A and the B agent tank 31B to the corresponding transfer devices 40A and 40B. The acidic concentrated liquid and the basic concentrated liquid are separately transferred to the concentrated liquid pack 41 to be arranged. Then, the controller 20 gives a command to the transfer devices 40A and 40B to move to the location of the dialysis device 4A assigned to the dialysis patient. For example, it gives position information indicating the location of the dialysis apparatus 4A. Therefore, in the dialysis system 1 of the present embodiment, the work of transporting the powdered dialysis agent or the concentrated liquid by the medical staff is avoided, and the burden on the medical staff can be reduced.

By the way, in the case of the present embodiment, the controller 20 has a database DB in which patient information, which is information about the dialysis patient, is registered for each dialysis patient. Based on this database DB, the controller 20 allows a dialysis patient who plans to perform dialysis treatment to select a powder dialysis agent to be used. Therefore, in the dialysis system 1 of the present embodiment, the work of selecting the powder dialysis agent by the medical staff is avoided, human error is reduced, and each dialysis patient can receive the optimum dialysis treatment. ..

Further, in the case of the present embodiment, the controller 20 is adapted to adjust the amount of the concentrated solution according to the dialysis patient who is planning to perform the dialysis treatment based on the database DB. Therefore, in the dialysis system 1 of the present embodiment, it is suppressed that the medical staff finely adjusts the amount of the concentrated liquid after the controller 20 adjusts the concentrated liquid, the burden on the medical staff can be reduced, and the necessary and sufficient amount can be reduced. Since the dialysate is prepared, the amount of dialysate to be discarded can be reduced.

Further, in the case of the present embodiment, the controller 20 is adapted to adjust the concentrated liquid before a predetermined time of the scheduled time when the dialysis treatment is performed based on the database DB. Therefore, in the dialysis system 1 of the present embodiment, a concentrated liquid (acidic concentrated liquid and basic concentrated liquid) that is a precursor of the dialysate to be produced immediately before use can be obtained, so that an unnecessary reaction of the concentrated liquid is obtained. The burden on the medical staff who adjusts the concentrated liquid is reduced while properly holding the concentrated liquid for a longer period of time.

Further, in the case of the present embodiment, the controller 20 recognizes the location of the dialysis device 4A assigned to the dialysis patient based on the database DB, and gives information indicating the location to the transfer devices 40A and 40B. .. Therefore, in the dialysis system 1 of the present embodiment, it is possible to avoid making a mistake in the destination of the powder dialysis agent or the concentrated liquid.

(2) Second Embodiment Next, a part of the configuration of the dialysate supply system will be described as the second embodiment. The same reference numerals are given to the same configurations as those described above, and duplicate description will be omitted unless otherwise specified.

As shown in FIG. 10, in the concentrated liquid supply unit 3 of the present embodiment, the camera 14 of the robot arm 10 is omitted, and the drug mixing spoon 15 is newly provided.

The drug mixing spoon 15 is composed of a container portion 15A capable of storing a composition drug which is a component constituting a powder dialysis agent and a handle portion 15B which can be gripped by the grip portion 13. The drug mixing spoon 15 is provided with a weight sensing sensor (not shown) that senses the weight of the composition drug to be placed in the container portion 15A. The weight sensing sensor generates weight data indicating the weight of the composition drug to be put in the container portion 15A of the drug mixing spoon 15, and sends the weight data to the controller 20. By providing the weight sensing sensor on the robot arm 10 instead of the drug mixing spoon 15, the robot arm 10 itself may detect the weight of the composition drug.

In the controller 20, among the drug selection unit 23A, the drug mixing unit 23B, the dissolving unit 23C, and the transfer unit 23D in the control unit 23, the processing content of the drug selection unit 23A that executes the processing of the drug selection step SP1 in the drug selection area AR1 is It is different from the first embodiment.

In the drug selection area AR1 of the present embodiment, instead of the drug shelf 17 of the first embodiment, as shown in FIG. 11, a drug cassette 19 which is a container for storing the powder dialysis agent is provided as a powder dialysis agent. It is provided for each composition drug used in the formulation of. In the present embodiment, glacial acetic acid _(CH 3 COOH) as a pharmaceutical composition of the A agent, sodium chloride (NaCl), potassium chloride (KCl), magnesium chloride hexahydrate _{(MgCl 2 · 6H 2 O)} , calcium chloride dihydrate dihydrate _{(CaCl 2 · 2H 2 O)} , anhydrous sodium acetate _(CH 3 COONa) and glucose (glucose) is employed. In addition, sodium hydrogen carbonate (NaHCO ₃ ) is adopted as the composition agent of the agent B. These composition drugs are contained in the corresponding drug cassette 19, and the drug cassette 19 can discharge the composition drug in the drug cassette 19 from the supply mechanism 19A, for example, in response to a command from the drug selection unit 23A.

In the drug used by the dialysis patient in the database DB referred to by the drug selection unit 23A, for example, as shown in FIG. 12, various ion concentrations which are composition drugs of the powder dialysis drug prescribed by the medical staff are displayed. To. The ion concentration is input by the input unit 21 and registered in the database DB by the control unit 23, so that the ion concentration is associated with the patient ID of the dialysis patient to be prescribed by the medical staff. Based on these ion concentrations, the drug selection unit 23A recognizes the composition drug of agent A, which is one of the pair of powder dialysis agents to be contained in the concentrated solution, and the composition agent of agent B, which is the other of the pair. , Calculate the weight of the composition drug.

For example, the weight of sodium hydrogen carbonate is calculated as the composition agent of agent B based on the concentration of bicarbonate ions. Specifically, the molecular weight of sodium hydrogen carbonate is multiplied by the concentration of bicarbonate ion, 1000 is divided by the multiplication result to convert the unit, and the required dialysate amount is multiplied by the result. To. For example, in the case of the example shown in FIG. 12, the concentration of bicarbonate ion (27 mEq / L) × the molecular weight of sodium hydrogen carbonate (84.01 g / mol) ÷ 1000 × the required amount of dialysate (120 L) is calculated, and hydrogen carbonate is calculated. The weight of sodium (272.2 g) is calculated.

Further, the weight of potassium chloride is calculated as the composition agent of agent A based on the potassium ion concentration, the weight of calcium chloride is calculated as the composition agent of agent A based on the calcium ion concentration, and magnesium chloride is calculated based on the magnesium ion concentration. Is calculated as the composition agent of agent A. These calculation methods are the same as the above-mentioned calculation method of the weight of sodium hydrogen carbonate.

Further, the weight of glucose is calculated as the composition agent of Agent A based on the concentration of glucose. Specifically, the required amount of dialysate is multiplied by the glucose concentration. For example, in the case of the example shown in FIG. 12, the glucose concentration (100 mg / dL) × the required dialysate amount (120 L) × 100 is calculated, and the glucose weight (120 g) is calculated.

Further, the weights of glacial acetic acid and anhydrous sodium acetate are calculated as the composition agent of the agent A based on the concentration of acetate ion (CH ₃ COO ⁻ ). Specifically, 50% of the acetate ion concentration is the acetate ion concentration of glacial acetate, and the remaining 50% is the acetate ion concentration of anhydrous sodium acetate. Then, the molecular weight of glacial acetic acid is multiplied by the acetate ion concentration of glacial acetic acid, 1000 is divided by the multiplication result to convert the unit, and the required dialysate amount is multiplied by the result. For example, in the case of the example shown in FIG. 12, the concentration of acetate ion (4 mEq / L) ÷ 2 × the molecular weight of glacial acetic acid (82.03 g / mol) ÷ 1000 × the required amount of dialysate (120 L) is calculated, and glacial acetic acid is calculated. The weight of the quantity (19.7 g) is calculated. The method for calculating anhydrous sodium acetate is the same as the method for calculating the weight of glacial acetic acid.

Further, the weight of sodium chloride is calculated as the composition agent of the agent A based on the concentration of sodium. Specifically, sodium ion of sodium hydrogen carbonate and sodium ion of anhydrous sodium acetate are subtracted from the concentration of sodium, the molecular weight of sodium chloride is multiplied by the subtraction result, and 1000 is obtained for the multiplication result. Is divided to convert units, and the result is multiplied by the required amount of dialysate. For example, in the case of the example shown in FIG. 12, the sodium concentration (140 mEq / L) -sodium ion of sodium hydrogen carbonate (27 mEq / L) -sodium ion of anhydrous sodium acetate (2 mEq / L) is calculated. Then, this calculation result (111 mEq / L) × molecular weight of sodium chloride (58.44 g / mol) ÷ 1000 × required amount of dialysate (120 L) is calculated, and the weight of sodium chloride (778.4 g) is calculated. ..

When the drug selection unit 23A calculates the weight of the composition drug of the agent A to be contained in the concentrated liquid as described above, the drug selection unit 23A controls the robot arm 10 to prepare the agent A in the container portion 15A of the drug mixing spoon 15. To do.

Specifically, the drug selection unit 23A corresponds to each of the constituent drugs of the drug A in a predetermined order until the value shown in the weight data from the weight sensing sensor provided on the drug mixing spoon 15 reaches the calculated weight. From 19 to the container portion 15A of the drug mixing spoon 15. The agent A prepared in the container portion 15A of the drug mixing spoon 15 in this manner is charged into the funnel 34A for the agent A by the drug mixing portion 23B.

Further, when the drug selection unit 23A calculates the weight of the composition drug of the B agent to be contained in the concentrated liquid as described above, the drug selection unit 23A controls the robot arm 10 to control the B agent in the container portion 15A of the drug mixing spoon 15. Formulate.

Specifically, the drug selection unit 23A uses a drug cassette corresponding to sodium hydrogen carbonate, which is a composition drug of agent B, until the value shown in the weight data from the weight sensing sensor provided on the drug mixing spoon 15 reaches the calculated weight. From 19 is charged into the container portion 15A of the drug mixing spoon 15. The agent B prepared in the container portion of the agent mixing spoon 15 in this manner is put into the funnel for agent B 34B by the agent mixing portion 23B.

The drug mixing spoon 15 is common to the A agent and the B agent, provided that it is washed after each composition agent of the A agent is added and after the composition agent of the B agent is added. May be used, or the A agent and the B agent may be used separately. Further, the drug mixing spoon 15 may be discarded after the composition drug is added, and a new one may be used each time the composition drug is added.

As described above, in the case of the present embodiment, the ion concentration of the composition drug, which is a component constituting the powder dialysis agent, is registered in the database DB. In this case, the controller 20 calculates the weight of the composition drug from each ion concentration, and mixes the composition drug for the calculated weight based on the data given from the weight sensing sensor. Therefore, not only the burden on the medical staff who prepares the concentrated liquid can be further reduced, but also a human error related to the calculation of the weight of the composition drug corresponding to the ion concentration of the composition drug can be avoided.

In the second embodiment, a predetermined amount of the prepared agent A is put into the funnel 34A for the agent A and the predetermined amount of the prepared agent B is added to the funnel 34B for the agent B using the drug mixing spoon 15. Was put into. However, a predetermined amount of the composition drug of the agent A is directly put into the funnel 34A for the agent A and a predetermined amount of the composition drug of the agent B is put into the funnel 34B for the agent B without using the drug mixing spoon 15. You may. Specifically, for example, the drug cassette 19 and the funnel for agent A 34A and the drug cassette 19 and the funnel for agent B 34B are connected by individual tubes or the like, and the weight of the drug cassette 19 is increased. This can be achieved by using a configuration in which a sensing sensor is provided.

Further, the first embodiment and the second embodiment may be combined. Specifically, for example, the drug rack 17 of the first embodiment and the drug cassette 19 of the second embodiment are respectively installed in the drug selection area AR1. Then, the drug selection unit 23A switches between the first mode and the second mode according to the content displayed in the drug used in the database DB. In the first mode, as described above in the first embodiment, the powder dialysis agent to be put in the drug bottle 18 is put into the funnel 34A for the agent A or the funnel 34B for the agent B. In the second mode, as described above in the second embodiment, after the powder dialysis agent to be placed in the drug cassette 19 is prepared based on the ion concentration of the composition agent in the powder dialysis agent, the funnel 34A for agent A or It is put into the funnel 34B for agent B. In this way, the concentrated liquid can be transported regardless of whether the existing powder dialysis agent or the powder dialysis agent is prepared according to the prescription.

(3) Modified Example In the above embodiment, the transferors 40A and 40B transferred the concentrated liquid pack 41 to the dialysis apparatus 4A, 4B ... Or 4F in a state where the concentrated liquid was introduced into the concentrated liquid pack 41. .. However, the melting device may also serve as a transfer device. For example, in a state where the concentrated liquid is stored in the A agent tank 31A and the B agent tank of the mixer 30 in the dissolving apparatus, the robot arm 10 of the dissolving apparatus transfers the mixer 30 to the dialysis apparatus 4A, 4B ... Or 4F. Transfer. In this way, when the melting device also serves as a transfer device, the melting devices themselves transfer, so that the physical transfer devices 40A and 40B are omitted.

Further, in the above embodiment, the melting device is composed of the components of the robot arm 10, the mixer 30, the stirrer, and the concentrated liquid introducers 44A and 44B. However, the dissolving device may be composed of components other than the components of the above embodiment as long as the powder dialysis agent is dissolved in RO water to prepare a concentrated solution.

The present invention may be used in a dialysate supply system such as a dialysis system using a personal dialysis machine or a central dialysate supply system, or in the dialysis industry using a dialyzer.

1 ... Dialysis system, 2 ... RO device, 3 ... Concentrated liquid supply unit, 4A-4F ... Dialysis device, 10 ... Robot arm, 20 ... Controller, 21 ... Input unit, 22 ... storage unit, 23 ... control unit, 23A ... drug selection unit, 23B ... drug mixing unit, 23C ... dissolution unit, 23D ... transfer unit, 31A ... -A agent tank, 31B ... B agent tank, 34A ... A agent funnel, 34B ... B agent funnel, 40A, 40B ... transfer device, 41 ... concentrated liquid pack, 44A, 44B ... concentrated liquid introducer, AR1 ... drug selection area, AR2 ... drug mixing area, AR3 ... dissolution area, AR4 ... transfer area, AR5 ... disposal area.

Claims (13)

A dissolving device that dissolves two types of powdered dialysis agents, which are powdered dialysis agents, in RO water to prepare an acidic concentrate and a basic concentrate , respectively.
A transfer device capable of self-propelling to a dialysis device that purifies blood using the acidic concentrate and the dialysate obtained from the basic concentrate .
The melting device and the controller for controlling the transfer device are provided.
The controller
The melting device by controlling, the acidic concentrate for hemodialysis patients causes coordinated tank for the acid concentrates, to adjust the basic concentrates for dialysis patients in the tank for the basic concentrate, the adjusted the Rutotomoni acidified concentrate was transferred to a vessel for the acid concentrates which are disposed in the conveying device from a tank for the acid concentrates, the adjusted the basic concentrate the basic concentrate Transfer from the liquid tank to the basic concentrate container located in the transferor .
A dialysis system comprising giving a command to the transferor to move to the location of the dialysis apparatus assigned to the dialysis patient. The controller has a database in which patient information, which is information about the dialysis patient, is registered for each of the dialysis patients.
The dialysis system according to claim 1, wherein each dialysis patient who is scheduled to perform dialysis treatment selects the powder dialysis agent to be used based on the database. The second aspect of the present invention, wherein the controller adjusts the amount of the acidic concentrate and the basic concentrate according to the dialysis patient who plans to perform the dialysis treatment based on the database. Dialysis system. Claim 2 or claim 3 characterized in that the controller adjusts the acidic concentrate and the basic concentrate before a predetermined time of the scheduled time when the dialysis treatment is performed based on the database. The dialysis system described in. A second to a fourth aspect of the present invention, wherein the controller recognizes the location of the dialysis apparatus assigned to the dialysis patient based on the database, and gives information indicating the location to the transfer device. The dialysis system according to any. The transfer device moves from the transfer area where the acidic concentrate is transferred to the container for the acidic concentrate and the basic concentrate is transferred to the container for the basic concentrate to the dialysis apparatus.
The dialysis system according to claim 5. A plurality of composition agents, which are components constituting each of the powder dialysis agents, are individually stored in a plurality of containers.
Based on the database, the controller causes the required composition drug to be taken out from the container in which the composition drug is stored in the required weight.
The dialysis system according to any one of claims 2 to 6, wherein the dialysis system is characterized in that. When the container in which the composition drug is stored is empty, the controller causes the container to be discarded.
The dialysis system according to claim 7. The controller, when each of the ion concentration of a plurality of said composition agent is registered in the database, the weight of the composition the drug from each of said ion concentration calculated, the weight sensing the composition agent weight fraction was the calculated dialysis system according to claim 7 or claim 8, characterized in <br/> that make formulated on the basis of the data supplied from the sensor. The tank for the acidic concentrate and the tank for the basic concentrate are connected by a grippable connecting portion.
The dialysis system according to any one of claims 1 to 9, wherein the dialysis system is characterized in that. The melting device has a robot arm and
The robot arm grips the connecting portion, agitates the powder dialysis agent in the tank for the acidic concentrate and the RO water, and for powder dialysis in the tank for the basic concentrate. Stir the agent and the RO water
The dialysis system according to claim 10. The area for adjusting the acidic concentrated liquid and the basic concentrated liquid and the transfer area for transferring the adjusted acidic concentrated liquid and the basic concentrated liquid to the transfer device are different areas.
The dialysis system according to any one of claims 1 to 11, wherein the dialysis system is characterized in that. The adjustment of the acidic concentrate and the basic concentrate is performed in the drug mixing area by mixing the powder dialysis agent to be the acidic concentrate with the RO water and the powder dialysis agent to be the basic concentrate. The agent is mixed with the RO water, and in a dissolution area different from the drug mixing area, the powdered dialysis agent to be the mixed acidic concentrated solution is dissolved in the RO water and together with the basic concentrated solution. Dissolve the powder dialysis agent in the RO water.
The dialysis system according to claim 12, wherein the dialysis system is characterized in that.

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