JP7359573B2 - dialysis system - Google Patents

Description

The present invention relates to a dialysis system that supplies hemodialysate to a hemodialysis patient.

When performing hemodialysis, for example, hemodialysis (HD) by diffusion as disclosed in Patent Document 1, hemofiltration (HF) which removes and replaces body fluid by ultrafiltration, or a combination of these. A dialysis system that performs dialysis filtration (HDF) or the like is used.

Hemodialysis is a blood purification method that brings blood and dialysate into contact through a semipermeable membrane and removes target substances from the blood mainly by the principle of diffusion. Although hemodialysis has excellent removal efficiency for substances with a small molecular weight, the removal efficiency may decrease for substances with a medium molecular weight or more due to a decrease in the diffusion ability near the membrane surface.

On the other hand, hemodiafiltration is a blood purification method that applies pressure to filter blood (ultrafiltration) in conjunction with hemodialysis to remove target substances. Hemodiafiltration replenishes the body with dialysate equal to the amount of body fluid (filtrate) removed. Since any substance that can pass through the membrane pores can be removed, hemodiafiltration is superior to hemodialysis in removing high molecular weight substances and proteins.

The dialysate used in hemodiafiltration is replenished directly into the body. Therefore, it is essential to purify the dialysate by thorough daily management such as water quality control of the dialysis water used for the dialysate and management of equipment such as periodic disinfection and cleaning.

The relationship between cleaning of dialysate and the onset of long-term dialysis complications such as dialysis amyloidosis and MIA syndrome (chronic microinflammation, malnutrition, arteriosclerosis) is described in Non-Patent Document 1. .

For these reasons, dialysis water used for hemodiafiltration not only meets the water quality standards set by the Japanese Society for Dialysis Medicine, but also contains viable bacteria, endotoxin (ET: endotoxin of Gram-negative bacteria), and oligo DNA (ODN). It is important that microbiological contaminants such as (bacterial DNA fragments) and dialysis water chemical substances specified by the Japanese Society for Dialysis Medicine (2016 Edition Dialysis Fluid Water Quality Standards) are removed as much as possible. Such highly clean dialysis water is suitably produced by using, for example, a purified water production apparatus as described in claim 3 of Patent Document 2.

Patent No. 4813464 Tsutomu Kuno, “Dylysate Purification and Clinical Effects,” Clinical Engineering Vol. 19, No. 8, 2008 Patent No. 5923027

When treating with hemodialysis, it is desirable to provide an appropriate prescription depending on the health condition of each individual patient, for example, from the viewpoint of the hemodialysis treatment method, treatment conditions, and cleanliness of dialysis water.

However, in order to do this, it is necessary to conduct a chronological survey of information indicating, for example, hemodialysis treatment methods, treatment conditions, and the cleanliness of dialysis water, as well as a large amount of information that records changes in patients' symptoms up to the present. However, it is necessary to consider the appropriateness of the content of dialysis treatment. This may increase the burden on doctors, delay appropriate treatment of patients, and make it difficult for patients to understand their own symptoms.

Therefore, the present invention reduces the burden on doctors and enables them to quickly examine the validity of the content of dialysis treatment, thereby enabling doctors to appropriately prescribe hemodialysis treatment according to the patient's condition. The aim is to make it easier for patients to understand the effects of hemodialysis treatment for all patients and for each individual patient, and to make it easier for patients to understand the effects of hemodialysis treatment for themselves.

In order to solve the above problems, a dialysis system according to one aspect of the present invention includes type 1 data indicating the cleanliness of dialysis water, which is dialysate-conditioned water supplied to at least one patient, and a recording unit that records trend management information obtained by chronologically correlating and accumulating type 2 data indicating dialysis treatment results; and an output unit that outputs the trend management information recorded in the recording unit. Equipped with

According to the above configuration, by simply checking the trend management information recorded in the recording section, it is possible to quickly grasp time-series information about the cleanliness of dialysis water that affects the effectiveness of dialysis treatment, and also to Time-series information that records changes in patient symptoms can be quickly investigated while keeping in mind the correlation between

Therefore, a huge amount of information recording changes in a patient's symptoms up to the present can be investigated in chronological order while comparing it with information regarding the cleanliness of dialysis water administered to the patient. For this reason, for example, the patient's blood test values, which may fluctuate due to changes in the cleanliness of dialysis water, and the presence or absence of side effects of dialysis treatment, which may occur due to changes in the cleanliness of dialysis water, and the degree of side effects, etc. It becomes easier for doctors to understand the effects of dialysis treatment for all patients and for each individual patient, and it also becomes possible to easily examine the effect of dialysis treatment from a medium- to long-term perspective.

Thereby, for example, the doctor's effort to examine the validity of the content of dialysis treatment based on the cleanliness of the dialysis water used for dialysis treatment can be significantly reduced. Therefore, it is possible to reduce the burden on the doctor, prevent delays in patient treatment, and appropriately prescribe dialysis treatment according to the patient's condition.

In addition, by checking their own trend management information recorded in the recording section, patients can easily understand the effects of dialysis treatment and the presence and severity of side effects due to dialysis treatment. It can be made easier.

The recording unit may record the first type data and the second type data corresponding to a plurality of patients in association with patient identification information. As a result, even if the dialysis system has a configuration that supplies dialysate to multiple patients at the same time, by checking patient identification information, it is possible to appropriately and quickly examine the appropriateness of treatment content for each individual patient. .

The plurality of patients may include patients undergoing dialysis treatment at different treatment facilities. This makes it possible to use a huge amount of trend management information for multiple patients receiving dialysis treatment at each treatment facility, further improving the statistical reliability of the data used to consider dialysis treatment prescriptions. can.

a plurality of dialysate administration units that are individually provided to the plurality of patients and administer the dialysis water; and a plurality of dialysate administration units that administer the dialysis water to each of the patients over a predetermined period of time. The dialysis control unit may further include a dialysis control unit that individually controls the dialysis control unit.

According to the above configuration, for example, even when dialysis treatment is performed on a plurality of patients in parallel, the dialysis control unit individually controls each dialysate administration unit, thereby making it possible to uniformly adjust the dialysis time for each patient. Therefore, even if dialysis treatment is not performed for a plurality of patients at the same time, dialysis treatment can be appropriately performed for each patient in accordance with the dialysis start time of each patient.

further comprising a determination unit that determines the presence or absence of a trend abnormality in at least one of the first type data and the second type data based on the trend management information recorded in the recording unit, based on a determination criterion; When the determination unit determines that the trend abnormality exists, the output unit may notify the determination result to the outside.

According to the above configuration, by using the determination unit and the output unit, even if the determination unit determines that there is an abnormal trend in at least one of the type 1 data and the type 2 data, the abnormality can be quickly detected by the doctor. etc., and the validity of the content of dialysis treatment can be considered early and appropriately.

The determination unit may determine the presence or absence of the trend abnormality based on a three-sigma method, and the determination criterion may include at least one of an upper control limit value and a lower control limit value.

According to the above configuration, it is possible to appropriately determine the presence or absence of a trend abnormality in at least one of the first type data and the second type data based on the standard deviation in the trend-managed information group. Therefore, the validity of the content of dialysis treatment can be examined in detail, and dialysis treatment can be stably performed.

The dialysis water may be water for online hemodiafiltration (OHDF) treatment, and the second type data may include a measurement result of a dialysate replacement amount. According to this configuration, in online hemodiafiltration treatment where the cleanliness of dialysis water is particularly required, the recording unit records trend management information, so that changes over time between type 1 data and type 2 data can be quickly detected. You can check it. Therefore, it is possible to maintain good cleanliness of dialysis water over a long period of time, and to clarify the relationship between the cleanliness of dialysis water and therapeutic effects in online hemodiafiltration treatment.

It may further include a dialysis water production section that has an electrical regeneration deionization device and that produces the dialysis water. According to the electrical regeneration type deionization device, microbiological contaminants such as viable bacteria, endotoxins, and oligo DNA in dialysis water and dialysis water chemical substances specified by the Japanese Society for Dialysis Medicine (2016 Edition Dialysis Fluid Water Quality Standards) can be detected. can be brought close to zero.

The dialysis water production unit further includes a filtration device, and the dialysis water production unit passes raw water, which is any one of tap water, well water, ground water, and reprocessed water of dialysis wastewater, through the filtration device and the dialysis water production unit. The water for dialysis may be produced by treatment with an electroregenerative deionization device. As a result, even if the quality of the raw water is not stable, for example, by using the filtration device and the electrical regeneration type deionization device, dialysis treatment can be appropriately performed using dialysis water of good quality.

The first type data may include information regarding at least one of the electrical conductivity of each water at a plurality of distribution points in the dialysis system 1 and the silica concentration of each water. Thereby, at least either the accumulated electric conductivity or the silica concentration can be managed over time, and dialysis treatment can be appropriately performed.

The first type data includes information on at least one of the electrical conductivity of the dialysis water and the concentration of specific components of the dialysis water, and the specific components include live bacteria, endotoxin, oligo DNA, calcium, magnesium, at least one of potassium, sodium, antimony, fluoride, total chlorine, nitrate, copper, thallium, barium, beryllium, zinc, aluminum, arsenic, lead, silver, cadmium, chromium, selenium, silica, and mercury; Good too. Thereby, the concentration of the specific component in the dialysis water can be managed over time, so that dialysis treatment can be performed satisfactorily while maintaining the dialysis water at a high level of cleanliness.

The second type data includes the date and time of treatment, the amount of dialysate replaced, the type of dialyzer, the manufacturing lot of the dialyzer, the conditions of treatment, blood test results, degree of side effects, body temperature, heart rate, blood pressure, body weight, cardiothoracic ratio, Dialysis system information including dry weight (target weight at the end of dialysis), brain waves, temperature and humidity of the outside air at the time of treatment, atmospheric pressure, weather, temperature and humidity inside the treatment facility, and disinfection and cleaning conditions for the dialysis water line and dialysate line. The information may include at least one of daily management conditions, dietary information of the patient, medical knowledge, and medication history.

Thereby, the health condition of a patient undergoing dialysis treatment can be managed over time based on the above items, and dialysis treatment can be performed satisfactorily. In addition, the correlation between two pieces of information included in the second type data, the difference between two pieces of information included in the first type data, the difference between two pieces of information included in the second type data, or the first type data The correlation between the information included in the data and the information included in the second type data can be analyzed and determined based on the trend management information recorded in the recording unit 11.

The blood test results include urea nitrogen, creatinine, uric acid, sodium, chloride, potassium, calcium, phosphorus, intact PTH, red blood cells, hemoglobin, hematocrit, white blood cells, platelets, total iron binding capacity, ferritin, albumin, liver AST, liver Containing the measurement results of at least one of ALT, liver γ-GTP, alkaline hostase, HBs antigen, HCV antibody, thyroid stimulating hormone, triiodothyronine, thyrotisine, β2-microglobin, blood sugar level, and total cholesterol. Good too. Thereby, by managing the health condition of a patient undergoing dialysis treatment over time based on the above-mentioned items, the validity of the content of dialysis treatment can be satisfactorily examined from the aspect of blood test results.

The degree of the side effects is determined from among the following: itch, general weakness, twitching of limbs, nausea, dizziness, multi-level evaluation of headache, degree of symptoms of chronic slight inflammation, degree of malnutrition, and degree of symptoms of arteriosclerosis. It may include at least one piece of information.

According to the above configuration, by managing the condition of a patient undergoing dialysis treatment over time based on the above items, the validity of the content of dialysis treatment can be well examined from the aspect of the degree of side effects of the patient undergoing dialysis treatment. can.

The second type data may include a plurality of pieces of information, and the output unit may output two or more pieces of information selected from the plurality of pieces of information in association with each other. Thereby, the correlation between the information included in the accumulated type 2 data can be examined, and the validity of dialysis treatment can be statistically examined from various aspects. The two or more pieces of information include a combination of at least one of the following information: the type of dialyzer and blood test results, the type of dialyzer and the degree of side effects, and the blood test results and the degree of side effects. You can stay there.

The communication unit further includes a communication unit that mutually communicates with at least one terminal device, and an authentication unit that individually authenticates the patient, and the communication unit records the information in the recording unit when the patient is authenticated by the authentication unit. The trend management information of the authenticated patient may be transmitted from the output unit to the terminal device.

According to the above configuration, it is possible to appropriately prescribe dialysis treatment according to the patient's condition, and to protect the patient's personal information while transmitting personal information regarding the patient's dialysis treatment only to the patient through the terminal device. . In addition, the doctor can confirm through the terminal device that the dialysis treatment method and treatment conditions that the doctor instructs the medical office staff, etc. are being carried out appropriately, giving the doctor a sense of security. .

When the patient is authenticated by the authentication unit, the communication unit transfers the trend management information of the authenticated patient recorded in the recording unit to the trend management information assigned to the authenticated patient. It may also be sent to a terminal device.

According to the above configuration, it is possible to appropriately prescribe dialysis treatment according to the patient's condition, and to protect the patient's personal information while transmitting personal information regarding the patient's dialysis treatment only to the patient through the terminal device. . Furthermore, personal information regarding the patient's dialysis treatment can be communicated to the patient's relatives, nurses, etc. approved by the patient and the doctor through the terminal device. Additionally, the patient can confirm through the terminal device that the dialysis treatment method and treatment conditions desired by the patient are being appropriately implemented, giving the patient a sense of security.

It further includes a reservation information receiving unit that receives reservation information of the patient transmitted from the terminal device through the communication unit, and the reservation information includes a reservation for at least one of a treatment date, a treatment start time, and a treatment bed. It may be information.

According to the above configuration, it is possible to appropriately prescribe dialysis treatment according to the patient's condition, and the patient can easily make a reservation for the above-mentioned selection information for dialysis treatment from a terminal device even from outside the hospital. It can improve the convenience of receiving information.

Furthermore, even if it becomes necessary to perform dialysis treatment at a facility other than the facility where dialysis treatment is routinely received, such as when traveling, on a business trip, or in the event of a disaster, the procedures that occur at that time can be simplified and It becomes possible to shorten the time.

The medical device may further include a payment information reception unit that receives payment of the patient's dialysis treatment fee input into the terminal device through the communication unit. As a result, dialysis treatment can be appropriately prescribed according to the patient's condition, and the patient can settle the dialysis treatment fee through the terminal device, improving convenience for the patient when receiving dialysis treatment.

The settlement may be a settlement using virtual currency based on distributed network technology. This allows patients to make payments appropriately using highly reliable virtual currency.

According to the present invention, by reducing the burden on doctors and making it possible to quickly examine the validity of the content of dialysis treatment, it is possible to appropriately prescribe hemodialysis treatment according to the patient's condition, and the doctor can It is possible to easily understand the hemodialysis treatment effect as a whole and for each patient, and it is also possible to make it easier for the patient to understand his or her own hemodialysis treatment effect.

FIG. 1 is a schematic diagram of a dialysis system according to an embodiment. FIG. 2 is a functional block diagram of a dialysis management unit in FIG. 1. FIG. FIG. 3 is a diagram showing a table recorded in the recording section of FIG. 2; (a) to (h) are diagrams showing patterns in which the determination unit in FIG. 2 determines that there is an abnormal trend. 3 is a flowchart showing the operation of the dialysis management section of FIG. 2. FIG. It is a schematic diagram of the dialysis system concerning a modification.

[Overall configuration of dialysis system]
Hereinafter, embodiments will be described with reference to each figure. FIG. 1 is a schematic diagram of a dialysis system 1 according to an embodiment. FIG. 2 is a functional block diagram of the dialysis management section 4 of FIG. FIG. 3 is a diagram showing the table 8 recorded in the recording unit 11 of FIG. 2. The dialysis system 1 is, for example, a multi-patient dialysis system that performs hemodialysis on a plurality of patients at once using a dialysate.

As shown in FIGS. 1 and 2, the dialysis system 1 includes a dialysis water production section 2, a dialysate supply section 3, a dialysis management section 4, and at least one (in this case, a plurality of) dialysate administration sections 5. The dialysis water production unit 2 produces water for hemodialysis. This dialysis water is dialysate-conditioned water, and is purified water as an example. The dialysate of this embodiment is, for example, water for online hemodiafiltration treatment in which dialysis drugs (solutions A and B) are diluted and dissolved using dialysis water. The dialysis water production unit 2 has a filtration device 22 provided with a reverse osmosis (RO) membrane. The dialysis water production unit 2 produces dialysis water by ultrafiltrating raw water, such as tap water, well water, underground water, or reprocessed water from dialysis wastewater.

As in this embodiment, the dialysis water production unit 2 may further include an electroregenerative deionization (EDI) device 20. The electrical regeneration deionization device 20 is designed to prevent electrolytes that may be mixed into the water that may have an adverse effect on the human body (for example, endotoxins, microbiological contaminants such as oligo DNA, etc.) The dialysis water chemical substances specified by the standards) are removed by adsorption and desorption using an electrically reversible ion exchange resin (endotoxin and oligo DNA are rendered non-toxic). By having the electrical regeneration type deionization device 20, in the dialysis water production unit 2, electrolytes that may have an adverse effect on the human body are highly removed, and highly clean and reliable dialysis water is produced.

The dialysis water of this embodiment satisfies the water quality standards of less than 10 ^-6 CFU/mL and less than 0.001 EU/mL of microbiological contaminant concentration stipulated in JSDT Dialysate Water Quality Standards 2008, and is ISO 23500. : Has cleanliness that meets the "sterile and pyrogen-free" standards stipulated in 2011. Here, "CFU/mL" indicates viable cell count units, and "EU/mL" indicates endotoxin units.

Furthermore, the dialysis water of this embodiment satisfies the dialysis water chemical management standards described in the Japanese Society for Dialysis Medicine (2016 Edition Dialysis Fluid Water Quality Standards).

The dialysate supply unit 3 has a pump, and supplies the dialysate prepared by diluting and dissolving dialysis drugs (solutions A and B) using the dialysis water produced by the dialysis water production unit 2 to the dialysate administration unit. Supply to 5. The dialysis management section 4 is connected to the dialysate supply section 3, and manages the condition (cleanliness) of the dialysis water by correlating it with the health condition of the patient. The dialysis management unit 4 is configured using, for example, a personal computer.

The dialysis management section 4 is connected to a personal computer 6 in the medical office, and is also connected to a terminal device 7 individually assigned to a patient or installed in the medical office. The connection between the dialysis management section 4 and the personal computer 6 of the medical office and the connection between the dialysis management section 4 and the terminal device 7 may be either wireless or wired.

When the terminal device 7 is individually assigned to a patient, examples of the terminal device 7 include a smartphone, a tablet, etc. owned by the patient. When the terminal device 7 is installed in a medical office, the terminal device 7 may be a device common to a plurality of patients.

The dialysate administration section 5 performs hemodialysis by administering the dialysate supplied by the dialysate supply section 3 to the patient. The dialysate administration section 5 has a dialyzer (dialyzer) including a semipermeable membrane, is connected to the dialysate supply section 3, and is disposed at the bedside of each patient.

The dialysate administration unit 5 of this embodiment purifies the patient's blood using a predetermined hemodialysis method. Here, the dialysate administration section 5 removes solutes such as uremic toxins from the patient's body by the principle of diffusion by bringing the blood and dialysate into contact through a dialyzer, or the dialysate is added to the patient's body fluid. Removes solutes from the patient's body by partially replacing them (filtration). The dialysate administration unit 5 administers the dialysate to the patient by a pre-dilution method, for example, but is not limited to this, and may administer the dialysate to the patient by a post-dilution method or a simultaneous front-back dilution method.

[Specific configuration of dialysis system]
The dialysis management section 4 functionally includes a recording section 11, a determination section 12, a recording control section 13, an output section 14, a communication section 15, an authentication section 16, a reservation information reception section 17, and a payment information reception section 18. When the dialysis management section 4 is configured using a personal computer, for example, the recording section 11 is configured using at least one of storage devices such as ROM, RAM, and HDD, and each section 12 to 14, 16 to 18 is configured using a storage device such as ROM, RAM, and HDD. The communication unit 15 is configured using a communication device such as a modem. The recording unit 11 does not need to be placed inside the casing of the dialysis management unit 4, and may be, for example, a storage (server) on a network connected to the determination unit 12.

The recording unit 11 stores a management program for managing the dialysis system 1. The recording unit 11 also stores type 1 data indicating the cleanliness of dialysis water supplied to at least one patient and type 2 data indicating the patient's dialysis treatment results in a chronological manner. Record trend management information obtained by The recording control unit 13 controls the recording operation of the recording unit 11 based on a management program.

As shown in FIG. 3, the trend management information is specifically recorded in a table 8 stored in the recording unit 11. In Table 8, each trend management record information includes, for example, patient identification information, type 1 data, type 2 data, recording date and time, and weather data (temperature and humidity of outside air per day and throughout the year, atmospheric pressure, weather ) are recorded and stored in association with each other.

As the weather data, in this embodiment, measured values of a measuring device connected to the dialysis system 1 are used. The patient identification information includes, for example, the patient's name and ID information. Each of the first type data and the second type data includes a plurality of pieces of information shown below. The recording unit 11 of this embodiment records trend management information so as to record all information included in the first type data and the second type data.

The recording unit 11 of this embodiment records type 1 data and type 2 data corresponding to a plurality of patients in association with patient identification information. By referring to the patient identification information, it is possible to specify which patient each piece of trend management information relates to, and it is also possible to prevent errors caused by mixing up trend management information of different patients. Trend management information can be confirmed, for example, through the personal computer 6 at a medical office. Furthermore, as will be described later, the patient who has been authenticated by the authentication unit 16 can check his or her own trend management information through the terminal device 7.

The first type data includes information on at least one of the electrical conductivity of the dialysis water and the specific component concentration of the dialysis water (here, both). The electrical conductivity of dialysis water is measured using, for example, an electrical conductivity measuring device or a resistivity measuring device. The electrical conductivity of dialysis water increases as the number of ionic impurities in dialysis water increases, and decreases as the number of ionic impurities decreases. Therefore, the electrical conductivity of dialysis water serves as an index of the cleanliness of dialysis water. Note that the electrical conductivity of dialysis water may be measured as a specific resistance value.

Specific components of dialysis water include microbiological contaminants and dialysis water chemical substances defined by the Japanese Society for Dialysis Medicine (2016 Edition Dialysis Fluid Water Quality Standards), such as live bacteria, endotoxin, oligo DNA, calcium, Magnesium, potassium, sodium, antimony, fluoride, total chlorine, nitrate, copper, thallium, barium, beryllium, zinc, aluminum, arsenic, lead, silver, cadmium, chromium, selenium, silica (e.g. ionic silica, colloidal silica, etc.) ), and mercury (here, all). The characteristic components are not limited to these.

The specific component concentration of the dialysis water is measured, for example, by sampling and analyzing the dialysis water produced by the dialysis water production unit 2. In addition, when measuring the electrical conductivity and specific component concentration of the dialysis water of the first type data, it may be measured continuously or at time intervals. The first type data may be transmitted from the measuring device to the dialysis management unit 4, or may be input to the dialysis management unit 4 by an administrator or the like.

Type 2 data includes treatment conditions such as date and time of treatment, amount of dialysate replaced, dialyzer type, dialyzer manufacturing lot, dialysis drug information (including manufacturing lot), blood test results, degree of side effects, body temperature, and heart rate. , blood pressure, body weight, cardiothoracic ratio, dry weight, brain waves (including sleep brain waves), temperature and humidity of the outside air at the time of treatment, atmospheric pressure, weather, temperature and humidity inside the treatment facility, disinfection and cleaning conditions for dialysis water lines and dialysate lines. The information includes at least one of the daily management conditions of the dialysis system 1, including the patient's dietary information, medical findings written in medical records, etc., and medication history. The second type data is preferably input into the dialysis management unit 4 by a doctor, administrator, or the like. Furthermore, the patient's feelings, impressions, personal knowledge, etc. may be input into the dialysis management unit 4 by the patient himself/herself.

Here, the daily management conditions of the dialysis system 1 include, for example, an implementation record showing that the dialysis water line and the dialysate line were cleaned in a predetermined manner. Furthermore, the patient's dietary information includes at least one of the types of foods and seasonings, the amount ingested, and the cooking status (for example, raw food and the proportion of allergens contained). This meal information may be input into the dialysis management unit 4 by a doctor, medical office staff, or a person qualified to manage the patient's personal information, including the patient's family.

Blood test results include urea nitrogen, creatinine, uric acid, sodium, chloride, potassium, calcium, phosphorus, intact PTH, red blood cells, hemoglobin, hematocrit, white blood cells, platelets, total iron binding capacity, ferritin, albumin, liver AST, liver ALT. , liver γ-GTP, alkaline hostase, HBs antigen, HCV antibody, thyroid stimulating hormone, triiodothyronine, thyrotisine, β2-microglobin, blood sugar level, and total cholesterol.

In addition, the degree of side effects is determined from among the following: itch, general weakness, twitching of limbs, nausea, dizziness, headache, multi-level evaluation value, degree of symptoms of chronic slight inflammation, degree of malnutrition, and degree of symptoms of arteriosclerosis. Contains at least one piece of information.

Based on the trend management information recorded in the recording unit 11, the determination unit 12 determines the presence or absence of a trend abnormality in at least one of the first type data and the second type data in accordance with a determination criterion. The determination unit 12 of this embodiment uses all the trend management information recorded in the recording unit 11 as a determination target. The timing of the determination can be set as appropriate, and can be set, for example, immediately after the amount of trend management information necessary for the determination is recorded in the recording unit 11. When the determination unit 12 determines that there is an abnormal trend, the output unit 14 notifies the outside (in this embodiment, the personal computer 6 of the medical office) of the determination result.

As an example, the determining unit 12 of the present embodiment determines the presence or absence of such a trend abnormality based on the 3-sigma method (a management method using a Shewhart control chart based on JIS Z 9021:1998). The criterion in the 3-sigma method includes at least one of the upper control limit (+3σ) and the lower control limit (−3σ) (here, both). Here, σ refers to the standard deviation of each type of information group recorded at intervals.

According to the 3 sigma method, if even one piece of information exceeds the upper control limit (UCL) or lower control limit (LCL), or if a series of information shows a predetermined trend abnormal pattern, the state of the information is determined. However, it is not considered to be in a state of normal statistical control. Based on such a determination method, the determining unit 12 individually determines whether or not there is an abnormal trend in information included in each of all the first type data and the second type data. Thereby, in the dialysis system 1, the information included in each of all the first type data and all the second type data is statistically trend-managed.

Note that trend management based on the 3 sigma method can be realized, for example, by using commercially available trend management software (for example, the quality control system "Duespec" manufactured by Nippon Software Co., Ltd.).

Specifically, (a) to (h) of FIG. 4 are diagrams showing patterns in which the determination unit 12 of FIG. 2 determines that there is an abnormal trend. (a) to (h) in FIG. 4 show control limits (regions C, B, and A) calculated from (average value) ±3 (standard deviation σ).

Region C indicates a region within ±1σ. Region B indicates a region greater than +1σ and less than or equal to +2σ, and a region less than −1σ and greater than or equal to −2σ. Region A indicates a region greater than +2σ and less than or equal to +3σ, and a region less than −2σ and greater than or equal to −3σ. Each point in (a) to (h) of FIG. 4 indicates an information value of either type 1 data or type 2 data included in the trend management information. If the determining unit 12 determines that the tendency indicated by one piece of information or a series of information corresponds to one of the eight patterns shown in (a) to (h) in FIG. 4, it determines that there is an abnormal trend.

FIG. 4(a) is an example of an abnormal trend in which the information value of one point exceeds area A. FIG. 4B is an example of an abnormal trend in which nine information values are consecutively on the + side or on the same side. FIG. 4(c) is an example of an abnormal trend in which the information values of six points continuously increase or decrease. FIG. 4(d) is an example of an abnormal trend in which the information values of 14 points alternately increase and decrease.

FIG. 4(e) is an example of an abnormal trend in which the information values of two out of three consecutive points are in area A or an area beyond it. FIG. 4(f) is an example of an abnormal trend in which the information values of 4 points out of 5 consecutive points are in region B or a region beyond it. FIG. 4(g) is an example of an abnormal trend in which 15 consecutive information values exist in region C. FIG. 4(h) is an example of an abnormal trend in which the information values of eight consecutive points are in a region exceeding region C.

If the determination unit 12 determines that there is an abnormal trend regarding either of the information included in the first type data or the second type data, the doctor You can refer to trend management information at any time and easily consider it. This makes it possible to quickly identify the cause of the abnormal trend and examine the validity of the dialysis treatment.

The output unit 14 outputs the trend management information recorded in the recording unit 11. The output referred to here includes operations such as display on a display connected to the dialysis management unit 4 as well as transmission to a predetermined device such as a personal computer 6 in a medical office. The communication unit 15 communicates with at least one terminal device 7 .

The authentication unit 16 authenticates each patient individually. This authentication is performed, for example, by biometric authentication for identifying the patient. Specifically, biometric authentication is performed by authenticating at least one of a fingerprint, a face, an ear print, a vein, an iris, a voice print, a palm print, a retina, an eye blink, and handwriting. Note that the authentication unit 16 may individually authenticate each patient using, for example, a random number table, a password, or information unique to the patient (national identification number, name, telephone number, etc.).

In this embodiment, the terminal devices 7 are individually assigned to patients. When the patient is authenticated by the authentication unit 16, the communication unit 15 transmits the trend management information of the authenticated patient recorded in the recording unit 11 from the output unit 14 to the terminal device 7. This allows the patient to check his or her own trend management information through the terminal device 7.

In the terminal device 7 of this embodiment, an application program for receiving trend management information from the communication unit 15 is installed in advance. By operating this program, the patient can receive his or her own trend management information from the communication unit 15 through the terminal device 7, and can also confirm specific information included in the trend management information, for example, in a graph form. Therefore, the effects of dialysis treatment and health condition can be easily grasped.

The reservation information reception unit 17 receives patient reservation information transmitted from the terminal device 7 through the communication unit 15. The reservation information is, for example, reservation information regarding at least one of a treatment date, a treatment start time, and a treatment bed.

The payment information reception unit 18 receives payment of the patient's dialysis treatment fee input into the terminal device 7 through the communication unit 15 . The payment information reception section 18 is connected to the accounting section 21 included in the personal computer 6 of the medical office. Accounting information of the medical office is stored in the accounting unit 21, and the payment information receiving unit 18 transmits the received payment information for the patient's dialysis treatment fee to the accounting unit 21.

The liquidation referred to here is, for example, liquidation using virtual currency based on distributed network technology (here, distributed ledger technology such as blockchain), but is not limited thereto. Further, when the dialysis management unit 4 includes the payment information receiving unit 18, the terminal device 7 may have, for example, a credit card payment terminal function. This allows the patient to pay for dialysis treatment using a credit card.

[Operation of dialysis management department]
FIG. 5 is a flowchart showing the operation of the dialysis management section 4 of FIG. 2. As shown in FIG. 5, when the trend management information is recorded in the recording unit 11, the determination unit 12 determines whether at least one of the first type data and the second type data (here, The presence or absence of an abnormal trend in both cases is determined based on the criteria. In this embodiment, the determination unit 12 compares the trend of one or a series of information values included in the trend management information with each pattern of FIGS. 4(a) to (h) to determine whether there is an abnormal trend. (S1).

Specifically, the determination unit 12 performs step S1 every time the necessary number of trend management information is recorded in the recording unit 11 to determine the presence or absence of a trend abnormality in each pattern of FIGS. Execute. That is, the determination unit 12 determines the pattern of FIG. 4(a) for each recording, the pattern of FIG. 4(b) for every 9 consecutive recordings, the pattern of FIG. 4(c) for every 6th consecutive recording, Regarding the pattern in FIG. 4(d), step S1 is executed every 14 consecutive recordings.

Further, the determination unit 12 determines the pattern of FIG. 4(e) every 3 consecutive recordings, the pattern of FIG. 4(f) every 5th consecutive recording, and the pattern of FIG. 4(g) every 15th consecutive recording. , for the pattern shown in FIG. 4(g), step S1 is executed every eight consecutive recordings.

In S1, if the determining unit 12 determines that there is no trend abnormality (S1: N), it next determines whether the determination process has been completed for all the trend management information recorded in the recording unit 11 ( S4). In S4, if the determination unit 12 determines that the determination processing for all of the trend management information recorded in the recording unit 11 has not been completed (S4:N), the determination unit 12 returns the step to S1.

In S1, when determining that there is an abnormal trend (S1: Y), the determining unit 12 notifies the outside through the output unit 14 that there is an abnormal trend (S2). The output unit 14 provides this notification by, for example, displaying a screen on the personal computer 6 in the medical office or emitting a warning sound. After confirming this notification, the doctor or the like enters confirmation input into the personal computer 6 in the medical office.

Thereafter, the determining unit 12 determines whether or not a confirmation input regarding the notification has been made (S3). This confirmation input is performed, for example, by a doctor or the like inputting it into the personal computer 6 in the medical office. The output unit 14 continues to issue the notification until the determination unit 12 determines that a confirmation input regarding the notification has been made (S3: Y).

In S3, when the determination unit 12 determines that the confirmation input has been made (S3: Y), the determination unit 12 causes the output unit 14 to terminate the notification, and advances the step to S4. In S4, when the determination unit 12 determines that the determination process has been completed for all data (S4: Y), the flow ends.

In the dialysis system 1, the dialysis management unit 4 executes S1 to S4 to determine the trend abnormality of each pattern of FIGS. 4(a) to (h) for all the trend management information recorded in the recording unit 11. The presence or absence will be determined by the determination unit 12 without exception.

Here, the determination unit 12 selects specific information in the first type data (for example, electrical conductivity of dialysis water) and specific information in the second type data (for example, a certain specific information) based on the three sigma method. It may also be determined whether there is an abnormal trend in the value of a predetermined function having component concentration) as a variable.

In this case, the determination unit 12 calculates the function each time specific information in the first type data and specific information in the second type data are recorded in the recording unit 11, and calculates the function. Steps S1-S4 can be performed for the values. Thereby, the correlation itself between the first type data and the second type data can be trend-managed.

Trends that can be managed using this function include, for example, the correlation between two pieces of information contained in type 2 data, the difference between two pieces of information contained in type 1 data, or the difference between two pieces of information contained in type 2 data. Examples include, but are not limited to, differences between pieces of information or correlation between information included in the first type data and information included in the second type data.

As explained above, the dialysis system 1 includes a recording unit 11 that records trend management information obtained by chronologically associating and accumulating type 1 data and type 2 data; and an output unit 14 that outputs the trend management information. Therefore, by simply checking the trend management information recorded in the recording unit 11, it is possible to quickly grasp time-series information on the cleanliness of dialysis water that affects the effectiveness of dialysis treatment, and also to Time-series information recording changes in patient symptoms can be quickly investigated while paying attention to relationships.

Therefore, a huge amount of information recording changes in a patient's symptoms up to the present can be investigated in chronological order while comparing it with information regarding the cleanliness of dialysis water administered to the patient. For this reason, for example, the patient's blood test values, which may fluctuate due to changes in the cleanliness of dialysis water, and the presence or absence of side effects of dialysis treatment, which may occur due to changes in the cleanliness of dialysis water, and the degree of side effects, etc. It becomes easier for doctors to understand the effects of dialysis treatment for all patients and for each individual patient, and it also becomes possible to easily examine the effect of dialysis treatment from a medium- to long-term perspective.

Thereby, for example, the doctor's effort to examine the validity of the content of dialysis treatment based on the cleanliness of the dialysis water used for dialysis treatment can be significantly reduced. Therefore, it is possible to reduce the burden on the doctor, prevent delays in patient treatment, and appropriately prescribe dialysis treatment according to the patient's condition.

In addition, by checking the patient's own trend management information recorded in the recording unit 11, the patient can easily check the effects of dialysis treatment and the presence and extent of side effects due to dialysis treatment. It can be made easier to understand.

Furthermore, for example, if a patient is being treated with a multi-person hemodialysis system and it becomes necessary to consider obtaining a hemodialysis treatment effect suitable for the patient, the trends recorded in the recording unit 11 By referring to the management information, it becomes easier for doctors and patients to consult about dialysis treatment methods. This makes it easier to take measures such as, for example, changing the dialysis system in which a patient receives treatment to a personal hemodialysis system.

Further, in this embodiment, the recording unit 11 records a huge amount of trend management information (in this embodiment, at least all trend management information from the start of the patient's dialysis treatment using the dialysis system 1 to the present). do. Therefore, for example, even if a correlation is newly discovered in the future between some information included in the first type data and some information included in the second type data, the trend recorded in the recording unit 11 Management information can be quickly and statistically and comprehensively checked in the past. Therefore, according to the dialysis system 1, it is also possible to examine the validity of the content of dialysis treatment from a new perspective that will be discovered in the future.

For example, if knowledge is obtained in the future that the concentration of a specific component N in dialysis water has a particular effect on the dialysis treatment effect, a doctor can refer to the trend management information recorded in the recording unit 11 to The concentration of the specific component N in dialysis water during dialysis treatment given to patients and the dialysis treatment effect for each patient can be statistically studied retrospectively. In this way, according to the dialysis system 1, a dialysis treatment plan tailored to each patient can be easily considered from a new perspective.

For example, in the dialysis system 1 of the present embodiment, the dialysis water production unit 2 includes the electrical regeneration deionization device 20, so that the dialysis water production unit 2 is made of highly clean purified water from which the specific component N is highly removed. Dialysis treatment can be performed using dialysis water. As a result, it is possible to objectively confirm based on the trend management information that dialysis treatment was being appropriately performed on each patient before the relevant knowledge was obtained, and the validity of the content of dialysis treatment can be quickly and appropriately evaluated.

In addition, when dialysis treatment is performed simultaneously on a plurality of patients from one dialysate supply section 3 through a plurality of dialysate administration sections 5 as in the dialysis system 1 of this embodiment, the treatment given to these patients is The content will be the same under many dialysis conditions. In this case, whether or not the content of the dialysis treatment is appropriate for each patient can be easily confirmed by referring to the trend management information for each patient recorded in the recording unit 11. Therefore, according to dialysis system 1, individual patients can easily consider whether the dialysis treatment they are currently receiving is suitable for them, and can provide efficient and effective dialysis treatment without wasting money and time. You can receive dialysis treatment.

In addition, in the dialysis system 1 of the present embodiment, the recording unit 11 records a huge amount of trend management information regarding a plurality of patients. By referring to the trend management information of multiple patients recorded in , it is possible to quickly and statistically examine the trend management information of multiple patients. In this way, according to dialysis system 1, it is possible to automatically collect and investigate a huge amount of data from both the dialysate and the patient, which is almost impossible to do with manual investigation alone. In addition to considering the above, it is also possible to consider ways to further improve dialysis treatment.

Furthermore, since the recording unit 11 automatically records trend management information regarding a huge amount of type 1 data and type 2 data, the effort required to manually record these data can be eliminated and human error can be avoided. Trend management information can be recorded appropriately while avoiding this.

In addition, the recording unit 11 manages and records multiple types of information included in each of the first type data and the second type data, so that, for example, multiple types of information included in the first type data or , correlations between multiple types of information included in type 2 data can be examined over time. This makes it possible to examine not only the correlation between type 1 data and type 2 data, but also the validity of the content of dialysis treatment from a wide range of perspectives.

In addition, since the recording unit 11 records the first type data and the second type data corresponding to multiple patients in association with patient identification information, when the dialysis system 1 has a configuration that supplies dialysate to multiple patients at the same time, However, by confirming patient identification information, it is possible to appropriately and quickly examine the validity of treatment contents according to each individual patient.

In addition, by recording the trend management information of multiple patients by the recording unit 11, it is possible to improve the correlation between items such as the type of dialyzer and blood test results among the second data of multiple patients and the degree of side effects. etc. can be statistically examined. Thereby, it is possible to examine in detail which of the items belonging to the second type data influences the patient's side effects, and to what extent the influence exists.

Specifically, in this embodiment, the second type data includes a plurality of pieces of information, and the output unit 14 outputs two or more pieces of information selected from the pieces of information in association with each other. Thereby, the correlation between the information included in the accumulated type 2 data can be examined, and the validity of dialysis treatment can be statistically examined from various aspects. The two or more pieces of information include, for example, a combination of at least one of the types of dialyzer and blood test results, the type of dialyzer and the degree of side effects, and the blood test results and the degree of side effects.

Furthermore, since the dialysis system 1 includes the determination unit 12 and the output unit 14, by using the determination unit 12 and the output unit 14, it is possible to determine that there is an abnormal trend in at least one of the type 1 data and the type 2 data. Even when the determination unit 12 makes a determination, the abnormality can be promptly notified to a doctor, etc., and the validity of the content of dialysis treatment can be quickly and appropriately examined.

Further, the determination unit 12 determines the presence or absence of a trend abnormality based on the 3 sigma method, and since the determination criterion includes at least one of an upper control limit value and a lower control limit value, a trend-controlled information group Based on the standard deviation of , it is possible to appropriately determine the presence or absence of a trend abnormality in at least one of the first type data and the second type data. Therefore, the validity of the content of dialysis treatment can be examined in detail, and dialysis treatment can be stably performed.

Moreover, the dialysis water of this embodiment is water for online hemodiafiltration treatment, and the second type data includes the measurement result of the amount of dialysate replacement. For this reason, in online hemodiafiltration treatment where high purity of dialysis water is particularly required, the recording unit 11 records trend management information to quickly check changes over time between type 1 data and type 2 data. can. Therefore, it is possible to maintain good cleanliness of dialysis water over a long period of time, and to clarify the relationship between the cleanliness of dialysis water and therapeutic effects in online hemodiafiltration treatment.

The dialysis system 1 also includes a dialysis water production section 2 that includes an electrical regeneration deionization device 20 and that produces dialysis water. According to the electrical regeneration type deionization device 20, microbiological contaminants such as viable bacteria, endotoxins, and oligo DNA in dialysis water and dialysis water chemistry specified by the Japanese Society for Dialysis Medicine (2016 Edition Dialysis Fluid Water Quality Standards) can be detected. It is possible to bring matter closer to zero. This effect can be obtained by thorough daily management such as periodic disinfection and cleaning of the dialysis water and dialysate delivery line of the dialysis system 1.

Furthermore, the dialysis water production unit 2 of this embodiment includes a filtration device 22, and the dialysis water production unit 2 uses raw water that is any one of tap water, well water, ground water, and reprocessed water of dialysis wastewater. is processed by a filtration device 22 and an electroregenerative deionization device 20 to produce water for dialysis. As a result, even if the quality of raw water is not stable, for example, by using the filtration device 22 and the electroregeneration deionization device 20, dialysis treatment can be performed appropriately using dialysis water of good quality.

The first type data also includes information regarding at least one of the electrical conductivity of each water at a plurality of distribution points in the dialysis system 1 and the silica concentration of each water. Thereby, at least either the accumulated electric conductivity or the silica concentration can be managed over time, and dialysis treatment can be appropriately performed.

The first type data includes at least one of the electrical conductivity of the dialysis water and the concentration of specific components in the dialysis water, and the specific components include live bacteria, endotoxin, oligo DNA, calcium, magnesium, potassium, and sodium. , antimony, fluoride, total chlorine, nitrate, copper, thallium, barium, beryllium, zinc, aluminum, arsenic, lead, silver, cadmium, chromium, selenium, silica, and mercury. Therefore, since the concentration of each of the above specific components in the dialysis water can be managed over time, dialysis treatment can be performed satisfactorily while maintaining the dialysis water at a high level of cleanliness.

Type 2 data includes treatment date and time, amount of dialysate replaced, dialyzer type, dialyzer manufacturing lot, treatment conditions, blood test results, degree of side effects, body temperature, heart rate, blood pressure, body weight, cardiothoracic ratio, Weight, brain waves, temperature and humidity of the outside air at the date and time of treatment, atmospheric pressure, weather, temperature and humidity inside the treatment facility, daily management conditions of the dialysis system 1 including disinfection and cleaning conditions for the dialysis water line and dialysate line, and patient dietary information , medical knowledge, and medication history.

Therefore, the health condition of a patient undergoing dialysis treatment can be managed over time based on the above items, and dialysis treatment can be performed satisfactorily. In addition, the correlation between two pieces of information included in the second type data, the difference between two pieces of information included in the first type data, the difference between two pieces of information included in the second type data, or the first type data The correlation between the information included in the data and the information included in the second type data can be analyzed and determined based on the trend management information recorded in the recording unit 11.

In addition, blood test results include urea nitrogen, creatinine, uric acid, sodium, chloride, potassium, calcium, phosphorus, intact PTH, red blood cells, hemoglobin, hematocrit, white blood cells, platelets, total iron binding capacity, ferritin, albumin, liver AST, liver Contains measurement results of at least one of ALT, liver γ-GTP, alkaline hostase, HBs antigen, HCV antibody, thyroid stimulating hormone, triiodothyronine, thyrotisine, β2-microglobin, blood sugar level, and total cholesterol. . Thereby, by managing the health condition of a patient undergoing dialysis treatment over time based on the above-mentioned items, the validity of the content of dialysis treatment can be satisfactorily examined from the aspect of blood test results.

In addition, the degree of side effects includes information on at least one of the following: itch, general weakness, twitching of limbs, nausea, dizziness, headache, and the degree of symptoms of chronic slight inflammation, malnutrition, and arteriosclerosis. There is. Thereby, by managing the condition of a patient undergoing dialysis treatment over time based on the above items, the validity of the content of dialysis treatment can be well examined from the aspect of the degree of side effects of the patient undergoing dialysis treatment.

In the dialysis system 1, when the patient is authenticated by the authentication unit 16, the communication unit 15 transmits the trend management information of the authenticated patient recorded in the recording unit 11 from the output unit 14 to the terminal device 7. do. Therefore, it is possible to appropriately prescribe dialysis treatment according to the patient's condition, and to protect the patient's personal information while transmitting personal information regarding the patient's dialysis treatment only to the patient through the terminal device 7. In addition, the doctor can confirm through the terminal device 7 that the dialysis treatment method and treatment conditions that the doctor instructs the medical office staff, etc. are being carried out appropriately, giving the doctor a sense of security. be.

In the present embodiment, when the patient is authenticated by the authentication unit 16, the communication unit 15 transmits the trend management information of the authenticated patient recorded in the recording unit 11 to the terminal assigned to the authenticated patient. Send to device 7. Therefore, it is possible to appropriately prescribe dialysis treatment according to the patient's condition, and to transmit personal information regarding the patient's dialysis treatment only to the patient through the terminal device 7 while protecting the patient's personal information. Furthermore, personal information regarding the patient's dialysis treatment can be conveyed to the patient's relatives, nurses, etc. recognized by the patient and the doctor through the terminal device 7. Furthermore, the patient can confirm through the terminal device 7 that the treatment corresponding to the patient's desired dialysis treatment method and treatment conditions is being appropriately performed, which has the advantage of giving the patient a sense of security.

Further, since the patient can easily check the dialysis treatment effect through the terminal device 7, the patient can check the dialysis treatment effect in real time at the bedside, for example, during dialysis treatment. In addition, the burden on the doctor to explain the effects of dialysis treatment in detail to the patient can be reduced.

The dialysis system 1 also includes a reservation information reception unit 17 that receives patient reservation information transmitted from the terminal device 7 through the communication unit 15. Therefore, it is possible to appropriately prescribe dialysis treatment according to the patient's condition, and the patient can easily make a reservation for the above-mentioned selection information for dialysis treatment from the terminal device 7 even from outside the hospital, so that the patient can receive dialysis treatment. It can improve convenience at the time of delivery.

Furthermore, even if it becomes necessary to perform dialysis treatment at a facility other than the facility where dialysis treatment is routinely received, such as when traveling, on a business trip, or in the event of a disaster, the procedures that occur at that time can be simplified and It becomes possible to shorten the time.

The dialysis system 1 also includes a payment information receiving unit 18 that receives payment of a patient's dialysis treatment fee input into the terminal device 7 through the communication unit 15. Therefore, dialysis treatment can be appropriately prescribed according to the patient's condition, and the patient can settle the dialysis treatment fee through the terminal device 7, which improves the convenience of the patient when receiving dialysis treatment.

Further, the settlement of the patient's dialysis treatment cost in this embodiment is settlement using virtual currency based on distributed network technology. Therefore, patients can make payments appropriately using highly reliable virtual currency.

The above settlement may alternatively be carried out by the dialysis treatment facility. In this case, it is necessary to be able to verify with high reliability that the facility has alternatively settled the dialysis treatment costs for a specific patient. Therefore, in this case, it is preferable that the details of payment of dialysis treatment costs be recorded and kept by both the patient and the treatment facility.

In addition, when at least one of information on the electrical conductivity of dialysis water and information on the silica concentration of raw water is used as the first type data, the information may include, for example, raw water for producing dialysis water, and information on the silica concentration of raw water. , water obtained by treating raw water at multiple distribution points in the dialysis system 1 (e.g., the pre-treatment section for pre-treating the raw water, the filtration device 22, the electro-regenerative deionization device 20, etc.) It is desirable to include information about each type of water. By examining the accumulated type 1 data, for example, the type 1 Changes in data over time can be quickly checked, and if necessary, measures can be taken appropriately to improve the value of type 1 data.

Next, a modification of the dialysis system 1 will be described. In the first modification, the plurality of patients on whom the dialysis system 1 performs dialysis treatment include patients receiving dialysis treatment at different treatment facilities. Patient trend management information of each treatment facility is shared between multiple treatment facilities wirelessly or by wire. According to such a first modification, it is possible to use a huge amount of trend management information of multiple patients receiving dialysis treatment at each treatment facility, and it is possible to use the statistical information of the data used to consider the prescription of dialysis treatment. Reliability can be further improved.

FIG. 6 is a diagram showing a dialysis system according to a second modification. As shown in FIG. 6, the dialysis system of the second modification includes a plurality of dialysate administration units 5 that are individually provided to a plurality of patients and administer dialysis water, and a plurality of dialysate administration units 5 that are individually provided to administer dialysis water to each patient. The dialyzer further includes a dialysis control unit 9 that individually controls the plurality of dialysate administration units 5 so as to administer the dialysate over a period of time. The dialysis control unit 9 here manages the time during which the dialysate administration unit 5 administered dialysis water to the patient and the dialysate flow rate.

According to the dialysing fluid administering section 5 and the dialysis controlling section 9 of the second modified example, for example, even when dialysis treatment is performed on a plurality of patients in parallel, the dialysis controlling section 9 can control the dialysing fluid administering section 5. Individual control allows uniform adjustment of dialysis time for each patient. Therefore, even if dialysis treatment is not performed for a plurality of patients at the same time, dialysis treatment can be appropriately performed for each patient in accordance with the dialysis start time of each patient.

The present invention is not limited to the above-described embodiments, and the configuration can be changed, added, or deleted without departing from the spirit of the present invention. The dialysis system 1 may perform hemodialysis on only one patient. Further, the dialysis system 1 may be configured to perform hemodialysis using a dialysis method other than online hemofiltration dialysis, for example. For example, even if the dialysis system 1 is configured to perform normal hemodialysis (HD), effective dialysis treatment can be performed by using dialysis water purified using the electroregeneration deionization device 20. Further, the electrical regeneration type deionization device 20 is not essential, and for example, if the amount of unnecessary electrolyte in the raw water is small, the electrical regeneration type deionization device 20 may be omitted.

1 Dialysis system 2 Dialysis water production section 5 Dialysis fluid administration section 7 Terminal equipment 9 Dialysis control section 11 Recording section 12 Judgment section 14 Output section 15 Communication section 16 Authentication section 17 Reservation information reception section 18 Payment information reception section 20 Electric regeneration type withdrawal section Ion device 22 Filtration device

Claims (20)

Obtained by chronologically correlating and accumulating type 1 data indicating the cleanliness of dialysis water, which is dialysate-conditioned water supplied to the patient , and type 2 data indicating the patient's dialysis treatment results. a recording unit that records trend management information;
an output unit that outputs the trend management information recorded in the recording unit ,
The recording unit records the first type data and the second type data corresponding to a plurality of patients including patients receiving dialysis treatment at different treatment facilities in association with patient identification information,
The output unit outputs the trend management information including information about the patient to the terminal device by communicating with the terminal device operated by the patient himself,
The dialysis system is configured such that the trend management information of patients in the different treatment facilities is shared between a plurality of treatment facilities wirelessly or by wire. The first type data recorded by the recording unit in association with the patient identification information,
a measuring device that measures at least one of the electrical conductivity of the dialysis water and the specific component concentration of the dialysis water and transmits the first type data; and administering a dialysate using the dialysis water to the patient. The dialysis system according to claim 1, wherein the measurement device transmits the information while being wired or wirelessly connected to a dialysate supply unit that supplies the dialysate to at least one dialysate administration unit. . a plurality of dialysate administration units that are individually provided to the plurality of patients and administer the dialysis water;
The dialysis system according to claim 1 , further comprising a dialysis control unit that individually controls the plurality of dialysate administration units so as to administer the dialysis water to each patient over a predetermined period of time. further comprising a determination unit that determines the presence or absence of a trend abnormality in at least one of the first type data and the second type data based on the trend management information recorded in the recording unit, based on a determination criterion;
The dialysis system according to any one of claims 1 to 3 , wherein when the determination unit determines that the trend abnormality exists, the output unit notifies the outside of the determination result. The determination unit determines the presence or absence of the trend abnormality based on the 3 sigma method,
The dialysis system according to claim 4 , wherein the criterion includes at least one of an upper control limit value and a lower control limit value. The dialysis water is online hemodiafiltration treatment water,
The dialysis system according to any one of claims 1 to 5 , wherein the second type data includes a measurement result of a dialysate replacement amount. The dialysis system according to any one of claims 1 to 6 , further comprising a dialysis water production section that has an electroregenerative deionization device and that produces the dialysis water. The dialysis water production unit further includes a filtration device,
The dialysis water production unit processes raw water, which is any one of tap water, well water, ground water, and reprocessed water of dialysis wastewater, using the filtration device and the electrical regeneration deionization device to produce the dialysis water. The dialysis system according to claim 7 , which manufactures a dialysis system. The first type data includes information regarding at least one of the electrical conductivity of each water at a plurality of distribution points in the dialysis system 1 and the silica concentration of each water. The dialysis system according to any one of the items. The first type data includes at least one of the electrical conductivity of the dialysis water and the specific component concentration of the dialysis water,
The specific components include live bacteria, endotoxin, oligo DNA, calcium, magnesium, potassium, sodium, antimony, fluoride, total chlorine, nitrate, copper, thallium, barium, beryllium, zinc, aluminum, arsenic, lead, silver, and cadmium. The dialysis system according to any one of claims 1 to 9 , wherein the dialysis system is at least one of chromium, selenium, silica, and mercury. The second type data includes the date and time of treatment, the amount of dialysate replaced, the type of dialyzer, the manufacturing lot of the dialyzer, the conditions of treatment, blood test results, degree of side effects, body temperature, heart rate, blood pressure, body weight, cardiothoracic ratio, Dry weight, brain waves, temperature and humidity of the outside air at the date and time of treatment, atmospheric pressure, weather, temperature and humidity inside the treatment facility, daily management conditions of the dialysis system, including disinfection and cleaning conditions for the dialysis water line and dialysate line, and the patient's diet. The dialysis system according to any one of claims 1 to 10 , comprising at least one of information, medical knowledge, and medication history. The blood test results include urea nitrogen, creatinine, uric acid, sodium, chloride, potassium, calcium, phosphorus, intact PTH, red blood cells, hemoglobin, hemoglobin, hematocrit, white blood cells, platelets, total iron binding capacity, ferritin, albumin, liver AST, liver A claim that includes measurement results of at least one of ALT, liver γ-GTP, alkaline hostase, HBs antigen, HCV antibody, thyroid stimulating hormone, triiodothyronine, thyrotisine, β2-microglobin, blood glucose level, and total cholesterol. 12. The dialysis system according to item 11 . The degree of the side effects is determined from among the following: itch, general weakness, twitching of limbs, nausea, dizziness, multi-level evaluation of headache, degree of symptoms of chronic slight inflammation, degree of malnutrition, and degree of symptoms of arteriosclerosis. Dialysis system according to claim 11 or 12 , comprising at least one piece of information. The second type data includes a plurality of pieces of information,
The dialysis system according to claim 1, wherein the output unit outputs two or more pieces of information selected from the plurality of pieces of information in association with each other. The two or more pieces of information include a combination of at least one of the following: type of dialyzer and blood test results, type of dialyzer and degree of side effects, and blood test results and degree of side effects. The dialysis system according to item 14 . a communication unit that communicates with at least one of the terminal devices;
further comprising an authentication unit that individually authenticates the patient,
When the patient is authenticated by the authentication unit, the communication unit transmits the trend management information of the authenticated patient recorded in the recording unit from the output unit to the at least one terminal device. The dialysis system according to any one of claims 1 to 15 , which transmits. When the patient is authenticated by the authentication unit, the communication unit transfers the trend management information of the authenticated patient recorded in the recording unit to the trend management information assigned to the authenticated patient. 17. The dialysis system of claim 16 , transmitting to at least one terminal device. further comprising a reservation information reception unit that receives reservation information of the patient transmitted from the at least one terminal device through the communication unit,
The dialysis system according to claim 16 or 17 , wherein the reservation information is reservation information regarding at least one of a treatment date, a treatment start time, and a treatment bed. The dialysis system according to any one of claims 16 to 18 , further comprising a payment information reception unit that receives payment of the patient's dialysis treatment fee input into the at least one terminal device through the communication unit. 20. The dialysis system according to claim 19 , wherein the settlement is a virtual currency settlement based on distributed network technology.

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