JP2004242995A - Holder of dialyzer for dialysis therapy - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide dialytic technique for achieving priming by which air is prevented from being left in a dialyzer even when air inside a blood circuit passes through the dialyzer at the time of priming, and also the technique by which blood is effectively prevented from being remained and also efficiency is raised for removing substance to be removed from the blood of a patient. <P>SOLUTION: The holder of the dialyzer for dialysis therapy holds the dialyzer 15 for dialysis therapy, and has a mechanism for allowing the dialyzer to automatically perform a reciprocative movement in vertical or/and horizontal directions or a swing movement by angle within a predetermined range, during conducting the dialysis therapy. <P>COPYRIGHT: (C)2004,JPO&NCIPI

Description

【００４１】
かかる表からわかるように、血液から除去すべき尿毒素と呼ばれる成分のうちの４つについて測定した結果、明らかに本発明のホルダーによる改善効果が見られた。
【００４２】
そして、透析療法を終了したときには、回路やダイヤライザー内に残った血液を人体に戻すための返血作業を行うが、本発明の自動揺動ダイヤライザーホルダーを使用して縦方向または／および横方向の往復運動、または、予め設定した範囲の角度のスイング動作を行う揺動運動を自動的に行なわしめることによって、残血という問題を大きく改善することができるのである。
【００４３】
【発明の効果】
本発明の透析療法用ダイヤライザーのホルダーによれば、（１）プライミング時に血液回路内のエアーがダイヤライザーを通過した場合でもダイヤライザー内にエアーが残らないようにすることのできるプライミングを実現する透析技術、また、（２）残血の発生防止、あるいは（３）患者の血液から除去すべき物質の除去効率をより高くできる透析技術を提供することができるものである。
【図面の簡単な説明】
【図１】図１は、透析療法の装置構成概略図である。
【図２】図２は、本発明揺動動作の一つである往復運動を得る機構の例である。
【図３】図３は、本発明揺動動作の一つである一定角の揺動運動を得る機構の例である。
【図４】図４は、本発明の一例である自動スイング機構付ダイヤライザーホルダーの概略図である。
【図５】図５は、本発明のダイヤライザーのホルダーを装置的に実現するためのカップリングの断面構造例を示した概略図であり、時計方向と半時計方向の揺動動作機構の概略を説明したものである。
【符号の説明】
１：ダイヤライザー保持部
２：カップリング
３：減速器
４：ＤＣモーター
５：ベース
６：終端検知アーム
７：終端検知アーム
８：角度調整ボルト
９：保持部軸
１０：減速器軸
１１：透析液
１２：コンソール
１３：血液ポンプ
１４：ヘパリンポンプ
１５：ダイヤライザー
１６：血液回路[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to a holder for holding a dialyzer when performing dialysis therapy using a dialyzer for dialysis treatment.
[0002]
[Prior art]
Dialysis therapy is performed mainly for the purpose of purifying blood of patients with chronic renal failure.
[0003]
FIG. 1 schematically shows the configuration of the therapy apparatus.
[0004]
That is, in FIG.
(1) a console 12 having a function of supplying a dialysate 11, which is a component close to a physiological saline solution, and strictly removing excess water from the human body;
(2) a blood pump 13 for continuously flowing blood taken from the arm at a constant flow rate;
(3) a heparin pump 14 for injecting a liquid called heparin to be injected to prevent coagulation of blood that has exited the body;
(4) A dialyzer 15, which actually causes blood and dialysate to flow countercurrently and removes excess water and waste products via a semipermeable membrane,
(5) A blood circuit 16, which is a path between the human body via the blood pump 13 and the dialyzer 15 and returned to the human body,
Consists of
[0005]
Dialysis therapy is
a. Priming as preparation work,
b. Actual dialysis,
c. Blood return after completion,
And three steps.
[0006]
When performing such dialysis therapy, before the start of dialysis, it is necessary to replace the liquid in the blood circuit and the dialyzer with physiological saline every time, and this operation is called priming. This is an operation performed to prevent air in the circuit or sterile water in the dialyzer from entering the patient's body.
[0007]
When the air in the blood circuit passes through the dialyzer during this priming, some of the air that entered the dialyzer may remain without being exhausted, and if the saline does not flow completely even if it is continued to flow There is. For this purpose, for example, a person hits the dializer with forceps, or discharges air from a portion which does not come off by giving an impact by hand or the like.
[0008]
On the other hand, as an undesired phenomenon that occurs in the dialyzer during dialysis therapy, there is a problem of so-called residual blood.
[0009]
This is generally found in the hollow fiber inside the dialyzer or near the slow-flow outlet called the header, and refers to the phenomenon of blood clots, and the hollow fiber in which this occurs is restricted in flow and cannot perform its original function Things. In addition, when blood is collected at the end of dialysis, this blood remains in the hollow fiber and header even if it is replaced with physiological saline and can be confirmed by eyes, so patients have a bad image of blood not being completely returned to the body. Will have.
[0010]
Although this phenomenon of residual blood may vary slightly depending on the performance of the dialyzer itself and the patient, it is a problem that can occur with some differences in dialysis.In any case, it is necessary to reduce the occurrence as much as possible. It has been done.
[0011]
The present inventors have paid attention to the holding state of the dialyzer holder as one means for solving the above-mentioned problem.
[0012]
As the prior art relating to this holder, the one that should be mentioned in the prior art documents in particular cannot be found, and for example, there is, for example, one related to the entire dialysis device (Patent Documents 1 and 2). The dialyzer holder is required only to securely fix the dialyzer, and no special measures are taken to change or impact the velocity or direction of the fluid in the dialyzer during the dialysis treatment. (1) dialysis technology for preventing air from remaining in the dialyzer even when air in the blood circuit passes through the dialyzer during priming, and (2) prevention of generation of residual blood, Alternatively, it does not relate to (3) dialysis technology or the like that further enhances the removal efficiency of a substance to be removed from a patient's blood.
[0013]
[Patent Document 1] Japanese Patent Application Laid-Open No. 9-618
[Patent Document 2] JP-A-6-292722
[Problems to be solved by the invention]
An object of the present invention is to provide a dialysis technique that realizes priming that can prevent air from remaining in a dialyzer even when air in a blood circuit passes through a dialyzer during priming. Is to be provided.
[0016]
Another object of the present invention is to provide a dialysis technique that is effective in preventing the occurrence of residual blood. Another object of the present invention is to provide a dialysis technique capable of increasing the efficiency of removing a substance to be removed from a patient's blood.
[0017]
[Means for Solving the Problems]
The present inventors have conducted intensive studies on the above points, and as a result, by oscillating the dialyzer, it is possible to change the flow of blood and dialysate flowing in the dialyzer, Has been found to be very effective in achieving the above object, and has reached the following holder of the dialyzer of the present invention.
[0018]
That is, the holder of the dialyzer of the present invention holds the dialyzer for dialysis therapy, and during the execution of the dialysis therapy, the dialyzer for dialysis therapy is reciprocated in the vertical direction or / and the horizontal direction or set in advance. A dialyzer holder for dialysis therapy, having a mechanism for automatically performing a swinging motion for performing an angle swinging operation.
[0019]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, the holder of the dializer of the present invention will be described in more detail.
[0020]
The dialyzer holder of the present invention can promote the discharge of the air stagnated in the dialyzer at the time of priming by changing the flow of the blood and the dialysate flowing in the dialyzer described above.
[0021]
The holder of the dialyzer of the present invention holds a dialyzer for dialysis therapy and automatically performs a reciprocating motion in a vertical direction and / or a horizontal direction, or a swinging motion that performs a swing operation at a preset angle. Automatically, or both.
[0022]
In the present invention, "automatically perform reciprocating motion in the vertical direction and / or the horizontal direction" means that a reciprocating motion in a vertical direction, a diagonal direction, and a horizontal direction with respect to a floor surface is automatically performed by a human operation command operation. Operation. Usually, such reciprocating motion is obtained by a mechanism using a crank and a slider as shown in FIGS.
[0023]
Further, in the present invention, "automatically perform a swinging motion for performing a swing motion at a preset angle" means that a circular motion at a predetermined angle about the axis of the dializer holding unit is performed by a human operation command operation. Means an operation performed automatically. In order to swing a certain angle, the lever can be obtained by a lever crank mechanism or forward / reverse control of a motor as shown in FIGS. In particular, "automatically perform" means that a predetermined operation is continuously performed by power and a control mechanism other than a person.
[0024]
The device is required to be compact and quiet for any operation.
[0025]
Hereinafter, the present invention will be described in more detail with reference to the drawings. ,
FIG. 2 is a schematic configuration diagram showing an embodiment of a dializer holder with an automatic swinging mechanism that swings at a preset angle. The dial is held at a preset angle around the axis of a holding unit that holds the dializer. An operation principle for providing a mechanism for swinging the riser will be described.
[0026]
That is, the rotation from the DC motor 4 is decelerated by the speed reducer 3, and the shaft 9 of the holding unit 1 that actually holds the dializer and the shaft 10 of the speed reducer are connected by the coupling 2.
[0027]
The rotation direction of the DC motor 4 for swinging the dializer is controlled by the angle adjusting bolt 8 provided on the coupling 2, the terminal detection arm 7, and the terminal detection arm 6. The angle adjusting bolt 8 moves the terminal detection arm 6 by the rotation of the coupling, detects whether the terminal detection sensor of the terminal detection arm 6 is at the final position of normal rotation or reverse rotation, and controls the DC motor 4 using the signal. . FIG. 5 is a schematic view showing a cross-sectional view of the coupling, and schematically explains the clockwise and counterclockwise swing operation mechanisms.
[0028]
The rotation angle of the swing is adjusted by changing the position of the angle adjusting bolt. The speed can be freely changed by the volume of the DC motor control unit.
[0029]
Such a holder of the dialyzer of the present invention can impart a change in flow to blood and dialysate.
[0030]
This is not only related to the air discharge at the time of priming, but also has a great effect in preventing the above-mentioned generation of residual blood.
[0031]
That is, with the end of the dialysis treatment, a blood return operation of returning blood to the body is performed, but generally, the blood is replaced with a physiological saline similar to priming. At this time, a part of the blood attached to the hollow fiber and the header part of the dialyzer is not washed out even if the physiological saline is continuously flowed, so that the flow of the physiological saline as the replacement liquid is changed, The replacement effect can be enhanced.
[0032]
In the present invention, the reciprocating motion in the vertical direction or / and the horizontal direction, or the rocking motion for performing the swing motion at a preset angle is not particularly limited, but is preferably 15 to 40 times per minute, More preferably, the exercise is performed at a cycle of 20 to 30 times per minute.
[0033]
The rocking motion is not limited to a motion only on a plane, and may be a rocking motion following a three-dimensional trajectory. Further, the dializer itself may be accompanied by a motion of rotating (revolving, revolving, etc.).
[0034]
The use of the holder of the dialyzer of the present invention also has an effect that a high removal efficiency can be obtained in terms of whether a target substance can be removed from the blood of a patient during dialysis therapy.
[0035]
The formula for calculating the removal rate as an index is shown below. The following equation shows the degree of removal of the target substance before and after dialysis.
[0036]
Removal rate (%) = {(CB-CA) / CB} × 100 (%)
Here, CB represents the concentration of a certain substance in blood before dialysis, and CA represents the blood concentration of the same substance after dialysis.
[0037]
In order to enhance the substance removing effect of the dialyzer in this dialysis therapy, it is effective to increase the blood flow to the dialyzer or to change the flow of dialysate or blood. It is possible to change the flow of the dialysate as described above.
[0038]
Conventionally, in dialysis therapy, dialysis is usually performed while being fixed to a holder for holding a dialyzer.During this dialysis therapy, the dialyzer holder with an automatic swing mechanism of the present invention is used. By giving the oscillating motion to the dializer, the substance removing effect of the dializer can be enhanced.
[0039]
Table 1 shows the effect of removing the small molecular weight substance when the holder of the dialyzer of the present invention was used and when it was not used. UN is urea nitrogen, Cr is creatinine, UA is uric acid, and IP is phosphorus.
[0040]
[Table 1]

[0041]
As can be seen from the table, as a result of measuring four of the components called uretoxin to be removed from the blood, the improvement effect of the holder of the present invention was clearly observed.
[0042]
Then, when the dialysis treatment is completed, a blood return operation for returning the blood remaining in the circuit and the dialyzer to the human body is performed. However, using the automatic rocking dialyzer holder of the present invention, the blood is returned vertically and / or horizontally. The problem of residual blood can be greatly improved by automatically performing the reciprocating motion in the direction or the rocking motion for performing the swing motion in the angle within the preset range.
[0043]
【The invention's effect】
ADVANTAGE OF THE INVENTION According to the holder of the dialyzer for dialysis therapy of this invention, (1) The priming which can prevent air from remaining in a dialyzer even if the air in a blood circuit passes through a dializer at the time of priming is implement | achieved. It is also possible to provide a dialysis technique, which can provide (2) prevention of generation of residual blood, or (3) higher removal efficiency of a substance to be removed from a patient's blood.
[Brief description of the drawings]
FIG. 1 is a schematic diagram of an apparatus configuration for dialysis therapy.
FIG. 2 is an example of a mechanism for obtaining a reciprocating motion which is one of the swing operations according to the present invention.
FIG. 3 is an example of a mechanism for obtaining a swing motion at a constant angle, which is one of the swing motions of the present invention.
FIG. 4 is a schematic view of a dializer holder with an automatic swing mechanism as an example of the present invention.
FIG. 5 is a schematic view showing an example of a cross-sectional structure of a coupling for realizing the dializer holder of the present invention as a device, and schematically shows a clockwise and counterclockwise swing operation mechanism. Is explained.
[Explanation of symbols]
1: Dializer holding unit 2: Coupling 3: Reduction gear 4: DC motor 5: Base 6: Terminal detection arm 7: Terminal detection arm 8: Angle adjusting bolt 9: Holding unit shaft 10: Reducer shaft 11: Dialysate 12: console 13: blood pump 14: heparin pump 15: dialyzer 16: blood circuit

Claims (1)

Holding the dialyzer for dialysis therapy, during the execution of dialysis therapy, the dialyzer for dialysis therapy is caused to reciprocate vertically or / and horizontally, or to perform a swinging motion of performing a swing motion at a preset angle. A dialyzer holder for dialysis therapy, which has a mechanism for automatically performing it.

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