JP7203488B2 - hemodialysis machine - Google Patents

Description

TECHNICAL FIELD The present invention relates to a hemodialysis apparatus, and more particularly to a hemodialysis apparatus having water removal means for removing water during dialysis treatment.

Conventionally, there is known a hemodialysis apparatus that includes a dialyzer for hemodialysis, a blood circuit that is connected to the dialyzer and circulates blood, and a dialysate circuit that is connected to the dialyzer and circulates the dialysate. Among these, there is also known a dialyzer equipped with water removal means for removing water from the blood during dialysis treatment.
In addition, when performing dialysis treatment, set values for various setting items such as the treatment time for dialysis treatment, the target amount of water to be removed during treatment, and the water removal rate that is the amount of water removed per predetermined time are set. There is a known technique in which the water removal speed is set by setting a target water removal amount and treatment time, for example, which must be set in the control means (Patent Document 1).
It is also possible to change the above set values during dialysis treatment. There is known a technique (Patent Document 3) that calculates the water removal rate from the treatment time and updates the treatment time when the dialysis treatment is delayed.

JP-A-9-19497 JP-A-7-328110 Japanese Patent No. 3250745

Here, when changing the setting values of the setting items related to water removal during dialysis treatment, it is desired to maintain a specific setting value, for example, whether to emphasize the target amount of water removal or the treatment time. I have a request.
However, it cannot be said that the configuration of the above-mentioned patent document satisfactorily satisfies such a request, and the attending physician and the medical staff who operate the hemodialysis machine also review other set values when changing the set values. Sometimes I needed work.
In view of such problems, the present invention provides a hemodialysis apparatus capable of maintaining arbitrary set values when changing the set values of setting items related to water removal in dialysis treatment. is.

That is, the invention of claim 1 comprises a dialyzer that performs hemodialysis, a blood circuit that is connected to the dialyzer and circulates blood, a dialysate circuit that is connected to the dialyzer and circulates the dialysate, and the dialysis A hemodialysis apparatus comprising: water removal means for removing water from blood in a dialysis machine;
The control means displays any one of the treatment time, target amount of water removal, and speed of water removal on the touch panel in a selectable state, and prioritizes storing the selection item selected on the touch panel. setting item selection means; setting value updating means for updating setting values of other related setting items based on the changed setting value of the setting item;
When one setting item is stored in the priority setting item selection means and the setting value of one of the other two setting items is changed, the setting value updating means changes the priority setting item selection means. while maintaining the set value of the setting item stored in step 1, the setting value of the other setting item is updated based on the changed setting value of the one setting item.

According to the above invention, when changing the water removal speed as a setting item, for example, if the treatment time is selected in the priority setting item selection means, the target water removal amount is updated while maintaining the set value for the treatment time. can do.
In this way, the setting values of other setting items can be automatically updated while maintaining the setting values of any setting item, so that the medical staff can easily change the setting values. becomes possible.

FIG. 1 is a circuit diagram showing a hemodialysis apparatus according to this embodiment;

The present invention will be described below with reference to the illustrated embodiments. FIG. and a dialysate circuit 4 connected to the dialyzer 2 .
The hemodialysis apparatus 1 is controlled by the control means 5, and setting items for the dialysis treatment such as the treatment time of the dialysis treatment and the blood flow rate in the blood circuit 3 are set.
A touch panel 6 is connected to the control means 5 of the present embodiment, and the state of the hemodialysis apparatus 1 is displayed, and setting values for the setting items can be input to the control means 5. In addition, as will be described later, it is also possible to change the set values during treatment.

The blood circuit 3 is composed of an artery side passage 11 that is connected to the patient's blood vessel and takes out blood to the dialyzer 2, and a vein side passage 12 that returns blood that has been dialyzed by the dialyzer 2 to the patient, These passages are composed of flexible resin tubes. A blood pump 13 for feeding blood is provided in the arterial passage 11 .

The dialysate circuit 4 includes two identical first dialysate chambers 21 and second dialysate chambers 22, and the dialysate can be prepared in the hemodialyzer 1 of the present embodiment, It is equipped with an A liquid tank TA and a B liquid tank TB that store the A liquid and the B liquid, which are undiluted solutions of the dialysate.
The insides of the first and second dialysate chambers 21 and 22 are divided by partition walls such as diaphragms and pistons into supply chambers 21a and 22a for supplying fresh dialysate and for collecting used dialysate. It is divided into recovery chambers 21b and 22b.
A water supply passage 23 for circulating purified water and a dialysate supply passage 24 for circulating fresh dialysate to the dialyzer 2 are connected to the supply chambers 21a and 22a. A dialysate recovery passage 25 for circulating used dialysate and a dialysate drain passage 26 for discharging used dialysate to a drain tank (not shown) are connected.

The water supply passage 23 is communicated with purified water supply means (not shown) for supplying purified water, and a water supply pump P1 controlled by the control means 5 is provided. An A liquid passage 27A and a B liquid passage 27B are connected to the B liquid tank TB.
The downstream side of the water supply passage 23 is branched in two directions and connected to the supply chambers 21a and 22a of the first and second dialysate chambers 21 and 22. Liquid supply valves V1 and V2 that are opened and closed by are provided.
The A liquid passage 27A and the B liquid passage 27B are provided with an A liquid pump P2 and a B liquid pump P3, respectively, which are controlled by the control means 5, and supply predetermined amounts of the A liquid and the B liquid, respectively. The liquid is sent to the chambers 21a and 22a.
With such a configuration, purified water, liquid A, and liquid B flow into the supply chambers 21a and 22a, and dialysate can be prepared in the supply chambers 21a and 22a. It's like

The upstream portion of the dialysate supply passage 24 branches in two directions and is connected to the supply chambers 21a and 22a of the first and second dialysate chambers 21 and 22, respectively. Supply valves V3 and V4 are provided which are opened and closed by the control of .
In addition, the downstream portion of the dialysate supply passage 24 is connected to the dialyzer 2, and the upstream side of the connection portion with the dialyzer 2 includes an on-off valve V5 and an on-off valve that are opened and closed by the control of the control means 5. V6 are provided in series.

The downstream portion of the dialysate recovery passage 25 branches in two directions and is connected to the recovery chambers 21b and 22b of the first and second dialysate chambers 21 and 22, respectively. Recovery valves V7 and V8 that are opened and closed by are provided.
On the other hand, the upstream portion of the dialysate recovery passage 25 is connected to the dialyzer 2, and is provided with an on-off valve V9 that is opened and closed under the control of the control means 5, and a dialysate pump P4 that feeds the dialysate.

The dialysate drain passage 26 is branched in two directions at its upstream portion and connected to the recovery chambers 21b and 22b. is provided.

A bypass passage 31 is provided between a position upstream of the on-off valve V5 in the dialysate supply passage 24 and a position downstream of the on-off valve V9 in the dialysate recovery passage 25. ing.
The bypass passage 31 is provided with an on-off valve V12, and when a defect in the dialysate concentration is detected during dialysis treatment, the on-off valve V5 of the dialysate supply passage 24 and the dialysate recovery passage 25 are closed. By closing the on-off valve V9 and opening the on-off valve V12 of the bypass passage 31, the defective dialysate can be sent from the bypass passage 31 to the dialysate recovery passage 25 without passing through the dialyzer 2. It is possible.

In addition, between the position adjacent to the upstream side of the branched portion of the dialysate recovery passage 25 and the position adjacent to the downstream side of the branched portion of the dialysate drainage passage 26, a water removing means is provided. A water passage 32 and a water removal pump P5 are provided.
The water removal pump P5 is operated under the control of the control means 5, and is operated during dialysis treatment to remove water from the blood in the dialyzer 2. It is designed to discharge to

Further, between the on-off valve V5 and the on-off valve V6 in the dialysate supply passage 24 and between the drip chamber 11a provided in the arterial passage 11 in the blood circuit 3, a replacement fluid passage 33 as a fluid replacement means is provided. and a replacement fluid pump P6.
The replacement fluid pump P6 is operated under the control of the control means 5, and is operated during dialysis treatment to supply fresh dialysate flowing through the dialysate supply passage 24 to the artery side passage 11 of the blood circuit 3, and the dialysate to the patient.

The operation of the hemodialysis apparatus 1 having the above configuration will be described. While hemodialysis is performed, in the blood circuit 3, the blood pump 13 sends blood according to the blood flow rate set in the control means 5, and the blood is sent from the artery side passage 11. After the inflowing blood passes through the dialyzer 2, it flows through the vein side passage 12 and returns to the patient.
On the other hand, in the dialysate circuit 4, purified water, liquid A and liquid B alternately flow into the supply chambers 21a and 22a of the first and second dialysate chambers 21 and 22 from the water supply passage 23 and are mixed. fresh dialysate is prepared. In addition, the used dialysate is alternately discharged from the recovery chambers 21b and 22b through the dialysate drain passage 26 as the volumes of the supply chambers 21a and 22a increase.
On the other hand, into the recovery chambers 21b and 22b of the first and second dialysate chambers 21 and 22, the used dialysate that has passed through the dialyzer 2 by the dialysate pump P4 alternately flows into the recovery chambers 21b and 22b. The dialysate prepared alternately is supplied to the dialyzer 2 from the supply chambers 21a and 22a as the volume of the dialyzer 2 increases.

When water is removed from the blood during dialysis treatment, the control means 5 operates the water removal pump P5 provided in the water removal passage 32 to discharge liquid containing waste products from the blood in the dialyzer 2. The dialysate is drained from the dialysate drainage passage 26 via the water removal passage 32 .
Further, when fluid replacement is performed during dialysis treatment, the control means 5 operates the replacement fluid pump P6 provided in the replacement fluid passage 33 to supply the dialysate from the dialysate supply passage 24 to the artery side passage 11 via the replacement fluid passage 33. The dialysate is supplied to the drip chamber 11a of the artery side passage 11 and the dialysate is supplied to the patient.

When performing dialysis treatment using the hemodialysis apparatus 1 having the above configuration, the attending physician or medical staff can use the touch panel 6 connected to the control means 5 to perform dialysis treatment according to the physical condition of the patient. Setting values for such setting items are set.
The setting items include, for example, the treatment time from the start to the end of the dialysis treatment, the dialysate flow rate of the dialysate by the dialysate pump, and the blood flow rate of the blood by the blood pump 13. When removing water during the dialysis treatment, is the target amount of water to be removed by the end of treatment, the rate of water removal by the water removal pump P5, and the target amount of fluid to be replenished by the end of treatment when fluid replacement is performed during dialysis treatment, by the fluid replacement pump P6. There is replacement fluid flow.
Each of these setting items has a setting value, and when performing dialysis treatment, it is necessary to input a setting value for each setting item to the control means 5 via the touch panel 6 .
Here, for example, the target amount of water removal is a set value that can be calculated from the treatment time and the water removal speed. , the control means 5 can automatically calculate the target amount of water to be removed. Conversely, if the treatment time and the target water removal amount are set, the control means 5 can automatically calculate the water removal rate.

Further, after starting dialysis treatment in the hemodialysis apparatus 1, if for some reason the setting values of the setting items such as the treatment time and water removal speed are to be changed, the medical staff can use the touch panel 6 to change these setting values. can be changed.
However, when shortening the treatment time, for example, if only the treatment time is shortened and the set values of other setting items are not changed, the dialysis treatment may end before reaching the target water removal amount set at the start of the treatment. Become.
Therefore, there is a known technique for updating the setting values of the related setting items when the setting values of the required setting items are changed. In the event of a change, the control means 5 automatically update the associated setting values.
Here, the setting items for removing water during dialysis treatment include the target water removal amount and the water removal rate. Considering the burden on the patient, the water removal rate may be emphasized, or the set value to be changed may be different.
However, in the conventional hemodialysis apparatus 1, when the setting value of one setting item is changed, only the setting value of the corresponding setting item is updated, and the setting value of the other setting item is changed. it was never updated. Therefore, when updating the setting values of the other setting items, the medical staff had to manually update them.

In view of such problems, the control means 5 of the hemodialysis apparatus 1 according to the present invention includes any one setting item of the treatment time, the target amount of water removal, and the water removal rate among the setting items related to water removal. and setting value updating means 42 for updating the setting values of other related setting items based on the changed setting value of the setting item.
The priority setting item selection means 41 displays any one of the treatment time, the target amount of water removal, and the water removal speed on the touch panel 6 in a selectable state. is selected, the setting item is stored.
When the medical staff changes one of the remaining two setting items on the touch panel 6, the setting value updating means 42 updates the setting value of the setting item selected by the priority setting item selecting means 41. is maintained, the setting value of the other of the two setting items is updated based on the changed setting value of the setting item.

Specifically, when the treatment time is selected in the priority setting item selection means 41, if the setting value of the target water removal amount is changed, the setting value updating means 42 maintains the setting value of the treatment time. , the set value of the water removal speed is updated based on the changed set value of the target water removal amount.
With such a setting, it is possible to maintain the treatment time even when the target amount of water removal is increased or decreased.
Conversely, when the treatment time is selected by the priority setting item selection means 41, if the set value of the water removal rate is changed, the set value updating means 42 maintains the set value of the treatment time and changes the treatment time. The set value of the target water removal amount is updated based on the set value of the water removal rate.
When such setting is made, for example, even when the dehydration rate is changed according to the physical condition of the patient, the treatment time can be maintained.

Further, when the target water removal amount is selected in the priority setting item selection means 41, if the setting value of the treatment time is changed, the setting value updating means 42 maintains the setting value of the target water removal amount and changes the treatment to the changed treatment. The water removal speed set value is updated based on the time set value.
With such a setting, even if the treatment time is changed for some reason, it is possible to remove water by the predetermined target amount of water to be removed.
Conversely, when the target water removal amount is selected in the priority setting item selection means 41, if the set value of the water removal speed is changed, the set value updating means 42 maintains the set value of the target water removal amount and changes the water removal rate. The set value of the treatment time is updated based on the set value of the dewatering rate.
When such setting is made, for example, even when the water removal rate is changed according to the patient's physical condition, the preset target water removal amount can be maintained.

Furthermore, the water removal speed can be selected by the priority setting item selection means 41. In this case, if the setting value of the treatment time is changed, the setting value updating means 42 maintains the water removal speed setting value. , the set value of the target water removal amount is updated based on the changed set value of the treatment time.
Conversely, when the water removal speed is selected in the priority setting item selection means 41, if the setting value of the target water removal amount is changed, the setting value updating means 42 maintains the setting value of the water removal speed and changes the water removal speed. The treatment time setting value is updated based on the target water removal amount setting value.

An upper limit value and a lower limit value of the water removal speed are set in advance in the setting value updating means 42, and when the setting value of the water removal speed is updated by the setting value updating means 42, the updated water removal speed is When the value deviates from the range between the upper limit value and the lower limit value, it is possible to display that effect on the touch panel 6 and prompt the setting again.
As described above, according to the above-described embodiment, when setting values of other setting items are changed by selecting setting items to be maintained in the priority setting item selection means 41 in advance, the selected setting values are changed. While maintaining, other related setting values can be updated, and it is possible to change the setting values according to the wishes of the patient and the medical staff.

Although the hemodialysis apparatus 1 described in the above embodiment relates to a so-called personal dialysis apparatus, it can also be applied to a so-called dialysis monitoring apparatus.

1 hemodialyzer 2 dialyzer 3 blood circuit 4 dialysate circuit 5 control means 6 touch panel 32 water removal passage 41 priority setting item selection means 42 setting value updating means P5 water removal pump

Claims (2)

A dialyzer that performs hemodialysis, a blood circuit that is connected to the dialyzer and circulates blood, a dialysate circuit that is connected to the dialyzer and circulates the dialysate, and water is removed from the blood in the dialyzer. A hemodialysis apparatus comprising water removal means and control means for setting setting values for setting items for dialysis treatment, such as treatment time, target water removal amount, and water removal speed,
The control means displays any one of the treatment time, target amount of water removal, and speed of water removal on the touch panel in a selectable state, and prioritizes storing the selection item selected on the touch panel. setting item selection means; setting value updating means for updating setting values of other related setting items based on the changed setting value of the setting item;
When one setting item is stored in the priority setting item selection means and the setting value of one of the other two setting items is changed, the setting value updating means changes the priority setting item selection means. and updating the set value of the other setting item based on the changed set value of the one setting item while maintaining the set value of the setting item stored in the above. When the treatment time is selected by the priority setting item selection means and the target water removal amount is changed, the set value updating means changes the water removal rate based on the changed target water removal amount while maintaining the treatment time. Updated,
When the target water removal amount is selected in the priority setting item selection means, if the treatment time is changed, the set value updating means updates the water removal speed based on the changed treatment time while maintaining the target water removal amount. The hemodialysis apparatus according to claim 1, characterized in that:

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