JPS6252586B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to a blood processing device provided with an extracorporeal circulation circuit for taking out a patient's blood, supplying it to a blood processing device, and returning the processed blood into the patient.

As such blood processing devices, dialysis type or hypertype artificial kidneys, artificial lungs, artificial livers, plasma separators, etc. are currently in practical use. After blood processing is completed in such a blood processing apparatus, it is necessary to return the blood remaining in the extracorporeal circulation circuit to the patient. The remaining blood is, for example, 100 to
The amount of blood is as much as 300 ml, and since the patient's own blood forming function has decreased, it is preferable to collect this blood into the patient without leaving as much blood as possible. For this reason, conventionally, during collection operations, staff members apply vibrations to the blood tubes and blood processing devices that make up the extracorporeal circulation circuit to peel off the blood adhering to the inside and return it to the body. was.
Further, when using this type of blood processing device, sufficient sterilization is performed, and formalin, ethylene oxide gas, or the like is used for the sterilization. It is necessary to thoroughly wash such sterilizing agents, and it is desirable to wash them effectively.

An object of the present invention is to provide a blood processing device that makes it possible to effectively and efficiently remove substances adhering to the inside of the blood processing device.

The invention includes a pump for passing liquid into an extracorporeal circulation circuit, and a clamp for intermittently turning on and off (opening and shutting off) a flow path near a blood processor during operation of the pump in a cleaning or blood collection mode. is provided. The liquid pressure that rose during the release is suddenly released, causing the flow rate to suddenly increase. Each time the flow rate of the liquid inside the blood processing device is repeatedly changed in this way, a shock is applied to the inside of the blood processing device, making it impossible to effectively remove the blood or sterilizing agent attached to it. It becomes possible.

Next, an embodiment of the blood processing apparatus according to the present invention will be described with reference to the drawings. In Figure 1, patient 1
An artery needle attached to one end of a blood pipe 12 is inserted into the artery of the patient 11, and blood is taken out from the patient 11. The other end of the pipe 12 is connected to a drip chamber 13. A roller pump 14 is provided in the middle of the pipe 12, and blood drawn from the patient 11 is supplied to the drip chamber 13 by rotating the pump 14. Air is separated from the blood supplied to the drip chamber 13,
The blood that has passed through the drip chamber 13 is processed by a blood processor 15 such as a dialyzer. This treated blood is supplied to a drip chamber 16 to remove air bubbles, and the blood that exits the drip chamber 16 passes through a blood pipe 17.
is returned into the patient 11 through an intravenous needle located at the free end of the . In this way, an extracorporeal circulation circuit 18 is constructed, which passes through the pipe 12, the blood processing device 15, and the pipe 17.

A clamp 19 is used as a means for controlling the flow of the blood pipe 12 on and off on the patient side of the pump 14.
is provided. Similarly, the clamp 21 is connected to the pipe 17.
An air bubble detector 22 is disposed on the drip chamber 16 side of the clamp 21, and when air bubbles are present in the blood passing through the pipe 17, the air bubble detector 22 detects this and closes the clamp 21. Ru.

When the blood treatment is completed, the blood in the extracorporeal circulation circuit 18 is collected into the patient 11.
Remove the arterial needle that was inserted into the saline bottle 23 and insert it into the saline bottle 23 as shown by the dotted line. In this state, the clamps 19 and 21 are opened as shown at time _t1 in FIG. 2A and B, that is, the extracorporeal circulation circuit 18 is in a state where circulation is possible, and the pump 14 is opened as shown in FIG. 2E. make it work. Therefore, physiological saline is supplied to the blood processor 15 through the blood pipe 12, and the blood present in the pipe 12, blood processor 15, etc. is pushed out and returned to the patient 11. The supply amount of this physiological saline is determined by the extracorporeal circulation circuit 18.
It is made to approximately match the liquid volume in the tank.

When the supplied amount of saline reaches the predetermined value as shown in FIG. 2, both clamps 19 and 21 are closed at time _t2 as shown in FIGS. 2A and 2B. In this embodiment, the liquid in the extracorporeal circulation circuit 18 is circulated without passing through the patient 11 from time _t2 . For this purpose, the pump 14 and the clamp 1
Blood pipe 12 between 9 and drip chamber 16
A side pipe 24 is connected between the air bubble detector 22 and the blood pipe 17, and a clamp 25 is provided on the side pipe 24. As shown in FIG. 2D, the clamp 25 is closed from time _t1 , stopping the flow of blood in the side pipe 24, and allowing blood to flow through the side pipe 24 from time _t2 . Therefore pump 1
4, the liquid circulates through the subcirculation circuit 26 consisting of the pipe 12, the chamber 13, the blood processing device 15, the chamber 16, the pipe 17, and the side pipe 24, and this circulation causes the liquid to flow inside, especially inside the blood processing device 15. Blood adhering to the skin is effectively removed.

After the circulation in the sub-circulation circuit 26 has been carried out for a certain period of time, at time _t3, the clamp 25 is closed as shown in FIG. 2D, and the clamps 19 and 21 are opened as shown in FIGS. The circulation circuit 18 is put into a circulation state, and the subcirculation circuit 26 stops circulating. Physiological saline is supplied to the extracorporeal circulation circuit 18 again, and the physiological saline containing the blood that has been peeled off from the inner wall of the extracorporeal circulation circuit 18 is supplied to the patient 11.

In this invention, the flow rate of the liquid in the blood processing device 15 is repeatedly and rapidly changed. For this reason, in this example, a clamp 27 is provided in the blood outflow path of the blood processing device 15, and this clamp 27 is repeatedly controlled on and off. Also, in this example, the clamp 27
opens when the arterial pressure reaches the set upper limit and closes when the set lower limit is reached.

For this purpose, an arterial pressure detector 28 is provided in the drip chamber 13, and the arterial pressure detected thereby is supplied to comparators 29,31. Comparator 2
A lower limit set value and an upper limit set value are applied to terminals 9 and 31 from terminals 32 and 33, respectively.
When the detected pressure of the arterial pressure detector 28 becomes less than the lower limit set value, the output of the comparator 29 becomes high level, the flip-flop 34 is set, and this set output is given to the control circuit 35, which controls the clamp 27. close.

As shown in FIG. 2C, the clamp 27 is closed, for example at time t ₁ , so that the pressure in the blood processor 15 increases as shown in FIG. 2F. When this pressure exceeds the upper limit setting, the output of comparator 31 goes high, which resets flip-flop 34. This reset causes the control circuit 35 to open the clamp 27. By the time the clamp 27 is opened, the blood processor 15
The high pressure of the liquid inside is suddenly released, causing the liquid to flow rapidly and its flow rate to become faster. The impact of this flow causes the blood adhering to the wall of the blood processing device 15 to fall.

As the clamp 27 is opened, the pressure in the arterial detector 28 gradually decreases as shown in FIG. The clamp 27 is closed. As this process is repeated, the flow rate inside the blood processing device 15 increases rapidly, and the blood adhering to the inner wall of the blood processing device 15 is removed. For example, if such an operation is performed in the second
Continue the blood collection operation as shown in the figure until it is completed. The end of blood collection is at time _t4 , when physiological saline is injected again from time _t3 and a predetermined amount has been delivered.
At this time t ₄ the clamp 21 is closed.

Control of these clamps 19, 21, 25, 27, etc. is performed through a control circuit 35. The control circuit 35 also detects the amount of saline supplied by the integrated value of the number of revolutions of the pump 14 or by the amount of change in the level of the saline in the saline bottle 23. Further, the time points t ₂ to t ₃ are determined, for example, by setting a timer. In order to rapidly change the flow velocity in the blood processing device 15, the clamp 27 was turned on and off, and the on/off control was performed by detecting the arterial pressure. Can be set arbitrarily. Alternatively, the clamp 27 may be controlled to be turned on and off at an appropriate repetition period without making such settings every time.

Blood adhesion during blood collection can be effectively and efficiently removed, and blood can be collected in a short time. Further, even when cleaning with a sterilant after sterilizing and cleaning such a blood processing device, it is possible to efficiently perform the cleaning by rapidly changing the flow rate inside the blood processing device.

[Brief explanation of the drawing]

FIG. 1 is a configuration diagram showing an example of a blood processing apparatus according to the present invention, and FIG. 2 is a time chart for explaining its operation. 11: Patient, 12, 17: Blood pipe, 13,
16: Drip chamber, 15: Blood processor, 1
4: Pump, 18: Extracorporeal circulation circuit, 19, 21,
25, 27: Clamp, 22: Air bubble detector, 2
8: Arterial pressure detector, 29, 31: Comparator, 34:
Flip-flop, 35: control circuit.

Claims (1)

[Claims] 1. A cleaning mode that includes an extracorporeal circulation circuit into which a blood processing device is inserted, and that cleans the extracorporeal circulation circuit;
A blood processing device having a blood processing mode in which blood is processed by the blood processing device, and a collection mode in which residual blood in the extracorporeal circulation circuit is collected after the blood processing is completed, wherein a liquid is passed through the extracorporeal circulation circuit. and a clamp that intermittently turns on and off a flow path near the blood processing device during operation of the pump in the cleaning mode and the recovery mode.