JPH0363065A - Artificial dialyser - Google Patents

Abstract

PURPOSE:To provide an artificial dialyser capable of accurately monitoring a dialytic state by mounting a dialyzing fluid supply circuit for supplying a dialyzing fluid to a dialyser main body and an external blood circulating circuit for supplying blood of a patient and providing a senser for measuring the absorbancy of blood to the said external blood circulating circuit. CONSTITUTION:An artificial dialyser is equipped with a dialyzing fluid supply circuit for supplying a dialyzing fluid to a dialyser main body 1 and an external blood circulating circuit 4 for supplying blood of a patient 3 to the dialyser main body 1. The external blood circulating circuit 4 is equipped with the blood flow passage 30 connected to the inlet 7a of the blood chamber 7 of the dialyser main body 1 and the blood flow passage 31 connected to the outlet 7b thereof. An artery pressure sensor 32 for monitoring the artery pressure of the patient and the photosensor 33 on the inlet side are provided to the blood flow passage 30. The photosensor 33 on the inlet side is constituted of a light emitting part and a light detection part to measure the absorbancy of blood. The photosensor 34 on the outlet side is provided to the blood flow passage 31 and also constituted of a light emitting part and a light detection part to measure the absorbancy of blood.

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to an artificial dialysis apparatus, and more particularly to an artificial dialysis apparatus for removing waste products and water from a patient's blood.

[Conventional technology]

A conventional artificial dialysis device includes a dialysis device main body having a dialysis membrane, a dialysis fluid supply circuit for supplying dialysate to the dialysis device body, and an extracorporeal circulation blood circuit for supplying patient's blood. In this device, waste products and water are transferred from the supplied blood to the dialysate side via the dialysis membrane in the dialysis device main body. This allows artificial dialysis to be performed.

[Problem to be solved by the invention]

During dialysis, the amount of water removed from the patient must be monitored. For this reason, conventionally, changes in a patient's weight are recorded and the amount of water removed is determined based on this.

Furthermore, in order to perform artificial dialysis over an appropriate amount of time (for example, several hours), it is necessary to monitor the dialysis rate of the artificial dialysis machine. In conventional configurations, blood is collected from the patient at regular time intervals and changes in hematocrit (volume concentration of red blood cells) in the blood are monitored.

In the conventional configuration for recording weight changes, the relationship between weight changes and the degree of progress of artificial dialysis is not so strong, and it is not possible to accurately know the degree of removal of waste products and water from the patient. Therefore, whether or not artificial dialysis was performed sufficiently depended largely on the experience of the doctor.

With the conventional configuration for blood sampling, it is not possible to collect blood frequently, and therefore the degree of dialysis of the dialysis apparatus cannot be accurately monitored. For this reason, the operating state of the dialysis machine has been determined based on the experience of the doctor.

An object of the present invention is to provide an artificial dialysis device that can accurately monitor the dialysis status.

[Means to solve the problem]

An artificial dialysis device according to the present invention includes a dialysis device main body having a dialysis membrane, a dialysis fluid supply circuit for supplying dialysate to the dialysis device main body, and an extracorporeally circulating blood supply circuit for supplying patient's blood to the dialysis device main body. It is equipped with a circuit. The extracorporeal circulation blood circuit has a sensor for measuring the absorbance of blood.

Note that the apparatus may further include a calculation means that receives an output signal from the sensor and calculates the degree of removal of waste products and water from the patient based on the signal.

Further, the sensor may be provided, for example, on the inlet side and the outlet side of the dialysis apparatus main body of the extracorporeal circulation blood circuit. Then, the artificial dialysis machine receives the output signal from the sensor,
The dialysis apparatus may further include calculation means for calculating the degree of dialysis of the dialysis apparatus main body based on the signal.

Furthermore, an adjusting means for adjusting the negative pressure on the dialysate side based on the calculation result by the calculating means may be provided.

[Effect]

In the artificial dialysis apparatus according to the present invention, in the dialysis apparatus main body, waste products and water are transferred from blood supplied through the extracorporeal circulation blood circuit to dialysate fluid supplied through the dialysate supply circuit via the dialysis membrane.

This performs artificial dialysis.

During dialysis, a sensor measures the absorbance of blood in the extracorporeal blood circuit. With this measurement, changes in blood hematocrit can be monitored. Since changes in hematocrit correspond to changes in the amount of water in the blood, the degree of dialysis can be determined by monitoring hematocrit.

For example, by calculating the degree of removal of waste products and water from the patient based on signals from sensors, it is possible to know the degree of progress of artificial dialysis in real time without drawing blood.

In addition, if sensors are installed on the inlet and outlet sides of the dialysis machine body of the extracorporeal circulation blood circuit, and the degree of dialysis in the dialysis machine body is calculated based on the signals from there, the dialysis level of the dialysis machine body can be calculated in real time without blood sampling. You can know the degree of dialysis.

〔Example〕

FIG. 1 shows an embodiment of the invention.

In the figure, the artificial dialysis machine includes a dialysis machine body 1 and a dialysate supply circuit' for supplying dialysate to the dialysis machine body 1.
2, and an extracorporeal circulation blood circuit 4 for supplying blood of a patient 3 to the dialysis apparatus main body 1.

The dialysis apparatus main body 1 is a container-shaped member, and is divided into a dialysate chamber 6 and a blood chamber 7 by a dialysis membrane 5.

The dialysate supply circuit 2 includes a concentrated liquid supply tank 8 that stores a concentrated dialysate, and a water supply path 9 that dilutes the concentrated dialysate to a predetermined concentration.

A filtration/decationization device 10 is provided in the water supply path 9 . Further, a proportional pump 11 is provided for supplying dialysate at a predetermined concentration to the dialysis apparatus main body 1 side while controlling the supply amount from the concentrated liquid supply tank 8 and the water supply path 9. A heating device 12 is provided downstream of the proportional pump 11 in the water supply path 9 to control the temperature of the dialysate. The heating device 12 has a temperature control device 13 equipped with a heating heater, and a temperature control probe 14 for monitoring the temperature of the heated water. On the downstream side of the heating device 12, the water from the water supply path 9 and the dialysate from the concentrated liquid supply tank 8 are configured to join together, and further downstream, the concentrated dialysate and water are mixed. , a mixing/deaeration chamber 15 for deaeration is provided. The mixing/deaeration chamber 15 includes a temperature monitoring probe 16 for monitoring the temperature of the dialysate that has been diluted to a predetermined concentration.
is provided. A conductivity measurement cell 17 for monitoring the concentration of dialysate is provided downstream of the mixing/deaeration chamber 15. The conductivity measurement cell 17 is composed of, for example, an ion electrode, and is capable of measuring the dialysate concentration by measuring the ion concentration in the dialysate. A pressure relief control valve 18 is provided downstream of the conductivity measurement cell 17 to adjust the flow rate of the dialysate using a needle. The outlet of the negative pressure 111fi valve 18 is connected to the inlet 6a of the dialysate chamber 6 of the dialyzer main body 1.

An outlet 6b of the dialysate chamber 6 is connected to a flow divider valve 20. A pressure relief sensor 21 for measuring pressure relief and a flow rate sensor 22 for measuring the flow rate of dialysate are provided between the outlet 6b and the flow dividing valve 20. A bypass 23 branching from the upstream side of the pressure relief control valve 18 is also connected to the flow dividing valve 20 . The flow dividing valve 20 is configured to adjust the flow rate on the dialysis apparatus main body 1 side and the flow rate on the bypass 23 side. Thereby, even if the flow rate on the side of the dialyzer main body 1 changes, the flow rate of the dialysate is controlled so as to remain constant as a whole. A blood outflow sensor 24 composed of a light emitting section and a light receiving section is provided downstream of the diversion valve 20.

Further downstream, a discharge pump 25 for discharging the dialysate is provided. The outlet of the drain pump 25 is connected to a drain reservoir 26 . The drained liquid in the drained liquid reservoir 26 is
The liquid is discharged to a drain pipe 28 by a drain pump 27.

The extracorporeal circulation blood circuit 4 includes a blood flow path 30 connected to the inlet 7a of the blood chamber 7 of the dialyzer main body 1, and a blood flow path 31 connected to the outlet 7b.

The blood flow path 30 has an arterial pressure sensor 32 for monitoring the patient's arterial pressure and an inlet side photosensor 33. The entrance side photosensor 33 is composed of a light emitting section and a light receiving section, and is used to measure the absorbance of blood. On the other hand, an exit side photosensor 34 is provided in the blood flow path 31. The exit side photosensor 34 also includes a light emitting section and a light receiving section, and is used to measure the absorbance of blood.

This artificial dialysis device includes a control unit 40@ as shown in FIG.
We are prepared. The control unit 40 includes a CPU, ROM, and RAM.
The controller is equipped with a microcomputer that performs control as described below. The control unit 40 includes the above-mentioned temperature adjustment probe 14, temperature monitoring probe 16, conductivity measurement cell 17, pressure relief sensor 21, flow rate sensor 22, blood outflow sensor 24, inlet side photosensor 33, outlet side photosensor 34, Arterial pressure sensors 32 are connected to each,
Various detections are performed based on these. Further, the above-mentioned proportional pump 11 , temperature adjustment device 13 , pressure relief control valve 18 , flow divider valve 20 , discharge pump 25 , and drain pump 27 are connected to the control unit 40 , and these are controlled by the control unit 40 . It is now possible to do so. Further, connected to the control section 40 are a key panel 41 for an operator to input commands to the control section 40, and a display section 42 such as a CRT for displaying operating conditions, calculation results, and the like.

In addition, the blood outflow sensor 24, both photosensors 33 and 34
The wavelength used in is 8 05 n, which corresponds to the isosbestic point.
It is m.

Next, the operation of the above embodiment will be explained.

By driving the proportional pump 11, the concentrated liquid supply tank 8
The concentrated dialysate inside and the water that has passed through the filtration/decationization device 10 are transported. In the proportional pump 11, the transport ratio is determined according to the dilution ratio of the dialysate. proportional pump 1
1 is heated to a predetermined temperature by a heating device 12. This temperature adjustment is performed by the temperature adjustment device 13 based on the temperature detected by the temperature adjustment probe 14. The heated water and concentrated dialysate are combined and mixed.
It is introduced into the deaeration chamber 15. Inside the mixing/deaeration chamber 15,
By mixing the concentrated dialysate and water, a dialysate with a predetermined concentration is produced, and the dialysate is degassed. The temperature of the dialysate in the mixing/degassing chamber 15 is monitored by a temperature monitoring probe 16 . Based on the temperature detected by the probe 16, the heating device 12 is controlled more accurately.

The dialysate coming out of the mixing/deaeration chamber 15 is transferred to the conductivity measurement cell 1.
The conductivity is measured by 7. The electrical conductivity measured here corresponds to the dialysate concentration, and the transport rate of the proportional pump 11 is controlled based on this. Conductivity measurement cell 17
The dialysate that has passed through passes through the pressure relief control valve 18 and is led into the dialysate chamber 6 of the dialyzer main body l. Pressure relief control valve 18
Then, by adjusting the needle, the flow rate is adjusted. Excess dialysate is distributed to the bypass 23 side.

The pressure of the dialysate coming out of the outlet 6b of the dialysate chamber 6 is detected by the pressure relief sensor 21. The pressure relief detected by the pressure relief sensor 21 is related to the dialysis rate in the dialysis machine main body 1, and the degree of dialysis in the dialysis machine body 1 can be known by measuring the pressure relief. Furthermore, the flow rate sensor 22 detects the flow rate of the dialysate coming out of the dialysate chamber 6. The diversion valve 20 allows the dialysate from the dialysate chamber 6 side and the dialysate from the bypass 23 side to join together. The blood outflow sensor 24 checks for blood outflow due to rupture of the dialysis membrane. If the dialysis membrane 5 ruptures, red blood cells will mix into the dialysate.
The absorbance of the dialysate at the blood outflow sensor 24 changes. This makes it possible to determine whether the dialysis membrane 5 has been torn. The discharge pump 25 forcibly discharges the dialysate from the dialyzer main body 1 side to the drain reservoir 26 . By controlling the discharge pump 25 and the pressure relief regulating valve 8, the pressure relief in the dialysate chamber 6 can be controlled. The dialysate stored in the drain reservoir 26 is discharged to a drain pipe 28 by a drain pump 27.

Once the above-described operations are performed regularly, the patient's 3's arterial blood is supplied to the blood chamber 7 of the dialysis apparatus main body 1 through the extracorporeal circulation blood circuit 4. In this case, arterial blood is introduced into the blood chamber 7 through the blood flow path 30 and returned to the patient 3 through the blood flow path 31. Arterial blood guided into the blood flow path 30 passes through an arterial pressure sensor 32, where the arterial pressure is detected.

Furthermore, the inlet side photosensor 33 detects the absorbance of the arterial blood before it enters the blood chamber 7. When blood is introduced into the blood chamber 7 , part of the waste products and water among the components of the blood migrate into the dialysate chamber 6 through the dialysis membrane 5 .

This performs artificial dialysis. The dialysis rate and volume are related to the magnitude of the pressure relief in the dialysate chamber 6 relative to the arterial pressure in the blood chamber 7. That is, by changing the pressure relief inside the dialysate chamber 6, the dialysis rate can be changed. The dialysis-treated arterial blood is returned to the patient's 3 body through the blood flow path 31. When passing through the blood flow path 31, the absorbance of the arterial blood is detected by the exit side photosensor 34.

Changes in the hematocrit (volume concentration of red blood cells) of arterial blood can be monitored using the detection results of the absorbance at the entrance side photosensor 33 and the exit side photosensor 34. By comparing the absorbance at the entrance side photosensor 33 and the absorbance at the outlet side photosensor 34, it is possible to know the degree of dialysis of the arterial blood that has passed through the dialysis apparatus main body 1. That is, it is possible to know how much water (and waste products) has been removed in the dialysis apparatus main body 1. The relationship between absorbance and hemadrit is as follows:
This is determined experimentally in advance, and the relational expression is stored in the ROM of the control unit 40 in advance. The control unit 40 displays the dialysis rate in the dialysis apparatus body l on the display unit 42, and integrates the dialysis rate from the start of dialysis. From this integral value, the total amount of water removed from the start of dialysis can be calculated. This total water removal amount is also displayed on the display section 42.
will be displayed. Furthermore, if the necessary water removal amount is stored in advance in the control section 40 through the key panel 41, the control section 40 compares the total water removal amount with the actual total water removal amount. If the planned total water removal amount matches the total water removal amount as a result of the integration, the end of dialysis is displayed on the display unit 42, and the pressure relief control valve 18 is closed to prevent dialysis from being performed more than necessary. controlled.

On the other hand, the absolute value of hematocrit calculated based on the absorbance from the exit side photosensor 34 is also displayed on the display section 42. If the amount of water in the blood decreases, the hematocrit value increases, so by looking at the displayed hematocrit value, it is possible to determine how much water has decreased in the patient's 3 body. Further, when it is determined that water has been sufficiently removed based on this hematocrit value, the control unit 40 closes the pressure relief control valve 18 and stops the dialysis operation. This prevents you from drawing more water than necessary.

When performing dialysis, an appropriate dialysis rate is required. Further, although the dialysis time usually lasts several hours, it is not preferable that the time be too short or too long. In the above embodiment, the entrance side photosensor 33 and the exit side photosensor 34
According to the hematocrit monitoring based on the hematocrit, the pressure relief is adjusted by adjusting the pressure relief control valve 18, and appropriate dialysis rate control is performed in real time. For this reason,
According to the embodiments described above, dialysis can always be performed at an appropriate dialysis rate and completed in an appropriate time.

Note that if it is sufficient to calculate the degree of removal of waste products and water from the patient 3, the entrance side photosensor 33 can be omitted. Further, calculations regarding the state of the patient 3 can also be performed using the entrance side photosensor 33.

〔Effect of the invention〕

According to the artificial dialysis apparatus according to the present invention, the dialysis state can be monitored in real time without drawing blood. Therefore, according to the present invention, more appropriate artificial dialysis can be performed.

According to the second invention, since it is possible to know the extent to which waste products and water are removed from the patient, it is possible to prevent unnecessary dialysis from being performed. Moreover, according to the third invention, the dialysis state of the dialysis apparatus main body can be monitored in real time, and the dialysis rate can be appropriately set.

[Brief explanation of drawings]

FIG. 1 is a schematic diagram of an embodiment of the present invention, and FIG. 2 is a block diagram of the control unit. 1... Dialysis apparatus main body, 2... Dialysate supply circuit, 3.
...Patient, 4. Extracorporeal circulation blood circuit, 5. Dialysis membrane, 33° 34. Photo sensor, 40. Control unit. Figure 1 1

Claims (4)

[Claims] (1) A dialysis device main body having a dialysis membrane, a dialysate supply circuit for supplying dialysate to the dialysis device main body, and an extracorporeal circulating blood circuit for supplying patient's blood to the dialysis device main body. , the extracorporeal circulation blood circuit has a sensor for measuring the absorbance of blood, an artificial dialysis device. (2) The artificial dialysis apparatus according to claim (1), further comprising calculation means for receiving an output signal from the sensor and calculating the degree of removal of waste products and water from the patient based on the signal. (3) The sensor is provided on the inlet side and the outlet side of the dialysis apparatus body of the extracorporeal circulation blood circuit, receives an output signal from the sensor, and calculates the degree of dialysis of the dialysis apparatus body based on the signal. The artificial dialysis apparatus according to claim (1), further comprising calculation means. (4) The artificial dialysis apparatus according to claim 2 or 3, further comprising adjustment means for adjusting the negative pressure on the dialysate side based on the calculation result by the calculation means.