JPH0779838B2 - Treatment device for progressive cerebral thrombosis - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION <Industrial field of application> The present invention relates to an apparatus for treating progressive cerebral thrombosis. More specifically, the present invention relates to an apparatus for treating cerebral thrombosis by collecting blood from a patient with progressive cerebral thrombosis, discarding blood cell components and returning only plasma components to improve blood circulation.

<Prior Art> When the lumen of a peripheral blood vessel (perforating branch), which is used for the motor center and sensory center of the brain, narrows and the blood flow in the perforating branch decreases,
The function of the central area is reduced, seizures, dizziness, memory loss, and prodromal symptoms such as dementia occur, but eventually the function of the central area is lost, that is, progressive cerebral thrombosis,
Symptoms such as hemiplegia, unilateral hypoesthesia, and speech disorders appear.

The causes of progressive cerebral thrombosis include narrowing of the lumen of arterial blood vessels due to cholesterol deposition, etc., and deterioration of cerebral blood circulation due to increase in hematocrit and plasma viscosity. As a treatment method, a method of removing the cause of thrombosis has been adopted, and conventionally, as a treatment method for progressive cerebral thrombosis, taking a vasodilator, a thrombolytic agent, an anticoagulant, a lipid lowering agent, etc., a phlebotomy therapy. , Methods such as inhaling carbon dioxide are used.

However, although the above-mentioned method has some effects, it cannot be said to be a definitive therapeutic method, and there are many drawbacks such as high cost and side effects.

Of the above methods, phlebotomy is a method that has been widely used since it is simple and economical.

For phlebotomy, conventional phlebotomy alone is used, phlebotomy is combined with physiological saline (hereinafter referred to as saline) or Ringer's replacement solution, and phlebotomy is given with albumin preparation or fresh frozen plasma. However, the method of performing only phlebotomy is not very effective, and there are cases in which the symptoms worsen due to a decrease in blood pressure, which is a problem. Further, the method of performing phlebotomy and simultaneously supplementing saline with a supplemental solution such as Ringer's solution can achieve the purpose of lowering blood viscosity, but is not satisfactory because the effect is small.

On the other hand, it has been confirmed that the method of administering an albumin preparation or fresh frozen plasma at the same time as phlebotomy has a great effect (Paulson OB: Neurology Vol. 20,
(Page 63, 1970), albumin is a problem because it is expensive and there is a risk of infectious diseases such as AIDS and hepatitis. Fresh frozen plasma is not only a problem with albumin but also fever and allergies due to leukocytes and platelets. This is a problem because there are side effects such as symptoms.

<Problems to be Solved by the Invention> The present invention has been made in view of the above problems, and an object thereof is to provide an effective and economical treatment device for progressive cerebral thrombosis. .

<Means for Solving Problems> As a result of intensive research to solve the above problems, the present inventor found that if autologous plasma is supplied at the same time as phlebotomy, that is, if phlebotomy of only blood cells is performed, it is stable and effective. The present invention has been accomplished by finding that various treatments can be performed.

That is, the present invention comprises a first clamp means and a blood pump in this order, a blood introduction line from a vein to a blood inlet of a plasma separator, a plasma separator, and a plasma pump. A plasma return line from a plasma outlet to a vein, a blood storage line from a blood outlet of the separator to a blood container, a blood container, and a second clamp means. The blood container to the first clamp means and a blood pump. Between the blood introduction line and the blood recirculation line, the replenishment pump is provided, and the replenishment line from the replenishment container to the blood circulation line and the replenishment container are provided. The present invention relates to a treatment device for progressive cerebral thrombosis, which is controlled so as to have an equal flow rate.

<Operation> Next, the operation of the treatment device for progressive cerebral thrombosis of the present invention will be described with reference to FIG.

Since the treatment device of the present invention is configured as described above,
In FIG. 1, by opening the first clamp (9) and closing the second clamp (12) to perform the operation, plasma can be separated from blood collected from the patient and returned. Next, the first clamp (9) is closed, the second clamp (12) is opened, and the operation is performed, whereby blood once stored in the blood container (5) (correctly, blood to which a replacement fluid has been added is stored. ) Is circulated through blood container (5) → blood circulation line (6) → blood introduction line (1) → plasma separator (2) → blood storage line (4) blood container (5) to further separate plasma. be able to.

<Example> Next, the Example of this invention is described based on drawing.

FIG. 1 is a view showing a flow path system of a treatment device for progressive cerebral thrombosis according to an embodiment of the present invention.

As shown in FIG. 1, the treatment apparatus of the present invention comprises a blood introduction line (1), a plasma separator (2), a plasma return line (3),
The blood storage line (4), the blood container (5), the blood circulation line (6), the replacement fluid line (7), and the replacement fluid container (8) are provided, and the plasma flow rate of the plasma return line (3) and the replacement fluid line ( It is controlled to be equal to the replacement fluid flow rate of 7). The first clamp (9) and the blood pump (10) are arranged in this order in the blood introduction line (1), and the plasma return line (3) and the replacement fluid line (7) also serve as replacement fluid pumps. The plasma pump (11) has a second clamp (12) arranged in the blood circulation line (6), and the blood circulation line (6) is connected to the first clamp (9) in the blood introduction line (1). Connected between blood pumps (10).

The blood introduction line (1) is a circuit for collecting blood from a patient's vein and introducing it into the plasma separator (2), and for collecting and flowing the first clamp (9) as clamp means and blood. The blood pump (10) as the power source of the device and preferably the drip chamber (18) as the bubble removing means are further provided in this order.

A blood circulation line (6) is connected between the first clamp (9) and the blood pump (10), and is preferably connected to the blood circulation line (6) upstream of the blood pump (10). An anticoagulant line (21) is connected downstream of the point.

The plasma separator (2) is a device for separating plasma from the blood supplied from the blood introduction line (1), and has a blood inlet, a blood outlet, and a plasma outlet, and the separation membrane is a hollow fiber membrane. As the material for forming the film, for example, cellulose triacetate, cellulose diacetate, polyacrylonitrile, vinylidene fluoride, polyolefin resin and the like can be preferably used.

The plasma return line (3) is a circuit for returning the plasma separated by the separator (2) to the patient's vein, the plasma pump (11) for flowing the plasma, and preferably as a bubble removing means. The drip chamber (19) is installed in this order.

The blood storage line (4) is a circuit for carrying the blood separated from the plasma in the separator (2) to the blood container (5) and storing it, and the replacement fluid line (7) and the drainage line (15) are They are connected in sequence, and a clamp (16) is provided between the connection point with the drainage line (15) and the blood container (5).

The blood container (5) is a container for storing the blood supplied from the blood storage line (4) (correctly, blood containing a replacement fluid), and is formed of, for example, vinyl chloride resin in a bag shape or a tank shape. Those that can be suitably used.

The blood circulation line (6) is a circuit for returning the blood stored in the blood container (5) to the blood introduction line (1), and a second clamp (12) as a clamping means is provided in the middle of the line. Has been done.

Here, the blood outlet (13) into the blood container (5) is preferably provided in the lower part of the container (5), and the blood inlet (14) from the container (5) to the blood circulation line (6) is a container. It is preferable to provide the intermediate portion of (5) (Experimental Example 1).

Further, the volume of the blood container (5) is determined so as to be approximately equal to the volume of blood to be collected.

The replacement fluid line (7) is for adding a replacement fluid in an amount equal to the amount of plasma lost from blood, for example, physiological saline (hereinafter referred to as saline) to the separated blood of plasma flowing through the blood retention line (4). The circuit is provided with a replacement fluid container (8) at one end, and a replacement fluid pump is installed on the way. However, in the embodiment, since the double pump is used to equalize the flow rate of plasma and the flow rate of the replacement fluid, the plasma pump (11) also serves as the replacement fluid pump.

The replacement fluid container (8) is a container for storing a replacement fluid such as saline or Ringer's solution, and is made of a material such as polypropylene, polyethylene, vinyl chloride resin, ethylene-vinyl acetate copolymer, or other material such as glass, and has a bag shape or a bottle shape. What is formed in is used.

Next, a method of using the treatment device of the present invention will be described.

First, the clamp (17) of the first clamp (9) and the drainage line (15) is opened, the clamp (16) of the second clamp (12) and the blood storage line (4) is closed, and the blood introduction line ( Blood introduction line (1) by introducing raw food etc. from 1) →
The plasma separator (2)-> blood storage line (4)-> drainage line (15) and saline are flown to prime the plasma separator (2).

Next, open the clamp (16), close the clamp (17), connect the indwelling needle (not shown), and connect the blood introduction line (1) and the plasma return line (3) to the patient's vein. Start driving.

The blood collected from the vein flows from the anticoagulant container (20) to the blood flow rate by the pump (22) while flowing through the blood introduction line (1) by the blood pump (10). A prescribed ratio of anticoagulant is added and fed to the plasma separator (2). And plasma is separated here,
The blood is stored in the blood container (5) through the blood storage line (4). On the other hand, the plasma separated by the separator (2) is returned to the patient's vein through the plasma return line (3) by the plasma pump (11), and at the same time, it is returned to the vein by the plasma pump (11) which also serves as a replacement fluid pump. The same amount of replacement fluid as the returned plasma is supplied from the replacement fluid container (8) to the blood container (5) through the replacement fluid line (7) and the blood storage line (4).

Next, when a prescribed amount of blood, for example, 500 ml of blood, is collected, the first clamp (9) is closed and the second clamp (1
2) Open to start operation.

The blood stored in the blood container (5) (correctly, blood containing a replacement fluid and an anticoagulant) is supplied by the blood pump (10) to the blood container (5) → blood circulation line (6) → blood introduction line ( 1) → Plasma separator (2) → Blood storage line (4) → Circulation of blood (correctly plasma containing a replacement fluid and an anticoagulant) continues to be circulated through a closed circuit of a blood container (5) ,
The plasma separated by the separator (2) is continuously returned to the patient's vein by the plasma pump (11) through the plasma return line (3). The blood container (5) is continuously supplied with the plasma pump (11) from the replacement liquid container (8) through the replacement liquid line (7) and the blood storage line (4). This operation is then continued until the amount of plasma returned (correctly the total amount of plasma plus replacement fluid and anticoagulant) is equal to the amount of blood collected.

<Example 1> In order to obtain the optimum position of the blood inlet / outlet in a blood container, the treatment apparatus of the present invention was operated under the following conditions.
The results shown in the table were obtained.

Blood used: 400 ml of bovine blood (Ht = 50%, TP = 6.2 g / dl) Method: 400 ml of bovine blood after priming, blood flow Q _B = 15 m
Operate at l / min, plasma flow rate Q _F = 4 ml / min. When 400 ml of bovine blood could be processed, the first clamp of the blood introduction line was closed and changed to Q _B = 60 ml / min Q _F = 15 ml / min and the total amount of separated plasma was increased.
Continue operation until 400 ml.

Blood bag: A vinyl chloride blood bag with a height of 165 mm and a width of 95 mm. However, the distance between the blood inlet side tube and the blood outlet side tube is about 50 mm, and the position of the blood inlet / outlet is from the top ... about 145 mm from the bottom, the middle part ... about 60 mm from the bottom, and the bottom ... 0 mm from the bottom. .

It can be seen from Table 1 that the recovery rate is best when the blood inlet is provided in the lower portion and the blood outlet is provided in the intermediate portion.

<Effects of the Invention> As can be seen from the above description, the following advantages can be obtained by using the treatment device of the present invention.

(1) Since the treatment device of the present invention is configured to separate plasma from blood from which plasma has been once separated, more plasma can be separated from blood collected from a patient. Therefore, more plasma can be returned to the patient, and effective treatment can be performed.

(2) It is economical because it uses serum separated from the patient's blood, that is, autologous serum, and side effects such as fever and allergic symptoms do not occur.

(3) Since the circuit is a closed circuit, there is no risk that the inside of the circuit will be contaminated by outside air during treatment, and therefore secondary infection can be prevented.

[Brief description of drawings]

 FIG. 1 is a diagram showing a flow path system of the treatment apparatus of the present invention. <Explanation of main symbols> 1: blood introduction line, 2: plasma separator 3: plasma return line, 4: blood storage line 5: blood container, 6: blood circulation line 7: replacement fluid line, 8: replacement fluid container 9: First clamp, 10: Blood pump 11: Plasma pump, 12: Second clamp

Claims (3)

[Claims] 1. A blood introducing line from a vein to a blood inlet of a plasma separator, a plasma separator, a plasma pump, and a first clamp means and a blood pump in this order. A plasma return line from a plasma outlet to a vein, a blood storage line from a blood outlet of the separator to a blood container, a blood container, and a second clamp means. The blood container to the first clamp means and a blood pump. Between the blood introduction line and the blood recirculation line, the replenishment pump is provided, and the replenishment line from the replenishment container to the blood circulation line and the replenishment container are provided. A treatment device for progressive cerebral thrombosis, which is controlled so that the flow rate becomes equal. 2. The plasma pump also serves as a replacement pump, and the flow passage cross-sectional areas of the plasma return line and the replenishment line are the same in the parts attached to the plasma pump. Treatment device. 3. A blood inflow position into the blood container is located at a lower portion of the blood container, and a blood outflow position from the blood container is located at an intermediate portion of the blood container. Alternatively, the treatment device according to the second item.