JP2018186904A - Blood purification device - Google Patents

Blood purification device Download PDF

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JP2018186904A
JP2018186904A JP2017089961A JP2017089961A JP2018186904A JP 2018186904 A JP2018186904 A JP 2018186904A JP 2017089961 A JP2017089961 A JP 2017089961A JP 2017089961 A JP2017089961 A JP 2017089961A JP 2018186904 A JP2018186904 A JP 2018186904A
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吉彦 佐野
Yoshihiko Sano
吉彦 佐野
豊世武 鵜川
Toyomu Ugawa
豊世武 鵜川
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Shizuoka University NUC
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Abstract

PROBLEM TO BE SOLVED: To provide a blood purification device that can be carried by a patient who needs a dialysis treatment so that regular hospital visits or restriction over a long time are not required, and, therefore, a burden on the patient is reduced.SOLUTION: A blood purification device 1 includes: a filtration part 3 for receiving blood B1 to be treated including a waste product A, and generating diluted blood B2 that does not contain a blood component BC and concentrated blood B3 that contains the blood component BC from the blood B1 to be treated respectively by ultrafiltration; and a reabsorption part 4 for discharging the diluted blood B2 whose moisture is reduced by causing the concentrated blood B3 to absorb the moisture contained in the diluted blood B2 as artificial urine U, and discharging the concentrated blood B3 that has absorbed the moisture as purified blood B4.SELECTED DRAWING: Figure 1

Description

本発明は、血液浄化装置に関する。   The present invention relates to a blood purification apparatus.

腎臓は、血液から老廃物や余分な水分などの人体に不要な成分を取り除く機能を有する。例えば、特許文献１に開示されている透過型濾過システムは、この機能を補助又は代替するいわゆる人工透析装置である。   The kidney has a function of removing unnecessary components such as waste products and excess water from the blood. For example, the permeation type filtration system disclosed in Patent Document 1 is a so-called artificial dialysis apparatus that assists or substitutes for this function.

特表２００２−５２８２４１号公報Special table 2002-528241 gazette

現在の人工透析装置は、老廃物の輸送原理の一つとして拡散現象を利用する。拡散現象によれば、血液に含まれる老廃物の濃度と老廃物に対応する成分を含む透析液の濃度との濃度差を駆動力として、老廃物を血液から透析液に移動させる。つまり、拡散現象を利用する人工透析装置は、例えば一回の透析治療につき１２０リットルといった大量の透析液が必要であるので、事実上持ち運ぶことができない。このような事情から、透析治療を必要とする患者は、例えば、定期的に通院すると共に所定時間に亘って拘束されるような透析治療を受けることがある。このような透析治療にあっては、患者のクオリティーオブライフ（ＱＯＬ）を向上させ難い。   Current artificial dialysis machines use the diffusion phenomenon as one of the transport principles of waste products. According to the diffusion phenomenon, the waste product is transferred from the blood to the dialysate using the concentration difference between the concentration of the waste product contained in the blood and the concentration of the dialysate containing the component corresponding to the waste product as a driving force. In other words, an artificial dialysis apparatus that uses the diffusion phenomenon requires a large amount of dialysis solution, for example, 120 liters per dialysis treatment, and therefore cannot be practically carried. Under such circumstances, a patient who needs dialysis treatment may, for example, receive dialysis treatment that regularly visits the hospital and is restrained for a predetermined time. In such dialysis treatment, it is difficult to improve the patient's quality of life (QOL).

そこで、本発明は、クオリティーオブライフ（ＱＯＬ）の向上が可能な血液浄化装置を提供する。   Therefore, the present invention provides a blood purification device capable of improving quality of life (QOL).

本発明の一形態は、除去対象成分を含む血液又は血液を含む液体である被処理液を受け入れて、限外濾過によって被処理液から除去対象成分を含み且つ血液成分を含まない第１処理液を生成すると共に血液成分を含む第２処理液を生成する濾過部と、第１処理液及び第２処理液を受け入れて、第１処理液が含む水分を第２処理液に吸収させることにより、水分が減少した第１処理液を排液として排出すると共に水分を吸収した第２処理液を浄化血液として排出する再吸収部と、を備える。   One aspect of the present invention is a first processing liquid that receives blood to be removed or a liquid to be treated that contains blood to be removed, and contains a liquid to be removed from the liquid to be treated by ultrafiltration and does not contain blood components. And the second processing liquid that receives the first processing liquid and the second processing liquid and absorbs the water contained in the first processing liquid by receiving the first processing liquid and the second processing liquid. A re-absorption unit that discharges the first treatment liquid with reduced moisture as drainage and discharges the second treatment liquid with absorbed moisture as purified blood.

この血液浄化装置は、濾過部において第１処理液を生成する。この第１処理液には、除去されるべき成分が含まれる。そうすると、第２処理液における除去対象成分は、被処理液における除去対象成分に比べて少なくなる。次に、血液浄化装置は、再吸収部において、第１処理液中の水分を第２処理液に吸収させる。この吸収により、第２処理液における血液成分の割合が被処理液と等価である浄化血液が得られる。この浄化血液は、除去対象成分の量が被処理液よりも小さいので、被処理液が浄化されたことになる。上述したように、血液浄化装置は、拡散現象を利用することなく被処理液から除去対象成分が取り除かれた浄化血液を得ることができる。そうすると、血液浄化装置は、透析液を必要としないので、患者が携帯可能な大きさまで小型化及び軽量化が可能である。従って、定期的な通院や長時間の拘束を要しなくなるので、患者の負担を軽減することができる。ひいては、血液浄化装置は患者のクオリティーオブライフ（ＱＯＬ）を向上させることができる。   This blood purification apparatus produces | generates a 1st process liquid in a filtration part. This first treatment liquid contains components to be removed. If it does so, the removal object component in a 2nd process liquid will decrease compared with the removal object component in a to-be-processed liquid. Next, the blood purification apparatus causes the second treatment liquid to absorb moisture in the first treatment liquid in the reabsorption unit. By this absorption, purified blood in which the ratio of blood components in the second processing liquid is equivalent to that of the liquid to be processed is obtained. In this purified blood, since the amount of the component to be removed is smaller than the liquid to be treated, the liquid to be treated has been purified. As described above, the blood purification apparatus can obtain purified blood from which the component to be removed has been removed from the liquid to be processed without using the diffusion phenomenon. Then, since the blood purification apparatus does not require dialysate, the blood purification apparatus can be reduced in size and weight to a size that can be carried by the patient. Therefore, it is not necessary to visit the hospital regularly or for a long time, so that the burden on the patient can be reduced. As a result, the blood purification apparatus can improve a patient's quality of life (QOL).

濾過部は、被処理液を受け入れる受入部と、第１処理液を排出する第１排出部と、第２処理液を排出する第２排出部と、受入部と第１排出部とを互いに隔てるように配置された第１処理膜と、を有し、再吸収部は、第１処理液を受け入れて、第１処理液を保持する第１保持部と、第２処理液を受け入れて、第２処理液を保持する第２保持部と、第１保持部と第２保持部とを互いに隔てるように配置された第２処理膜と、有し、第１処理膜は、血液成分より小さい第１細孔を有し、第１細孔より小さい除去対象成分を水分と共に通過させ、第２処理膜は、除去対象成分よりも小さい第２細孔を有し、第２細孔よりも小さい水分を通過させてもよい。   The filtration unit separates the receiving unit that receives the liquid to be processed, the first discharging unit that discharges the first processing liquid, the second discharging unit that discharges the second processing liquid, and the receiving unit and the first discharging unit. The reabsorbing unit receives the first processing liquid and holds the first processing liquid, and receives the second processing liquid, and receives the first processing liquid. (2) a second holding part for holding the treatment liquid, and a second treatment film disposed so as to separate the first holding part and the second holding part from each other, the first treatment film being smaller than the blood component. The removal target component having one pore and smaller than the first pore is allowed to pass along with moisture, and the second treatment film has second pores smaller than the removal target component and moisture smaller than the second pore. May be allowed to pass.

血液浄化装置は、受入部から濾過部へ被処理液を受け入れる。受け入れられた被処理液は、第１処理膜を通過して第１処理液となる。この第１処理膜は、血液成分より小さい第１細孔を有する。従って、第１処理液は、血液成分より小さい除去対象成分と水分とを含む。従って、濾過部によって、被処理液から第２処理液が得られる。次に、第１処理液と第２処理液は、再吸収部に送られる。再吸収部は、第１保持部における第１処理液と第２保持部における第２処理液とを第２処理膜によって隔てる。第２処理膜は、水分子よりも小さい第２細孔を有する。そうすると、第１処理液と第２処理液との浸透圧差に起因して、第１保持部における第１処理液から第２保持部における第２処理液への水分の移動が浸透圧差がなくなるまで継続する。この水分の移動により、第２処理液から浄化血液が得ることができる。   The blood purification apparatus receives the liquid to be processed from the receiving unit to the filtering unit. The received liquid to be processed passes through the first processing film and becomes the first processing liquid. The first treatment membrane has first pores smaller than blood components. Therefore, the first treatment liquid contains a component to be removed that is smaller than the blood component and moisture. Therefore, a 2nd process liquid is obtained from a to-be-processed liquid by a filtration part. Next, the first treatment liquid and the second treatment liquid are sent to the reabsorption unit. The reabsorption unit separates the first processing liquid in the first holding unit and the second processing liquid in the second holding unit by the second processing film. The second treatment membrane has second pores smaller than water molecules. Then, due to the difference in osmotic pressure between the first treatment liquid and the second treatment liquid, the movement of moisture from the first treatment liquid in the first holding unit to the second treatment liquid in the second holding unit until the osmotic pressure difference disappears. continue. Purified blood can be obtained from the second treatment liquid by this movement of moisture.

第１処理膜の分画分子量は６６，０００以下であり、かつ、第２処理膜の分画分子量は２０以上１００以下であってもよい。この構成によれば、浄化血液を好適に得ることができる。   The fractionated molecular weight of the first treated membrane may be 66,000 or less, and the fractionated molecular weight of the second treated membrane may be 20 or more and 100 or less. According to this configuration, purified blood can be suitably obtained.

一形態に係る血液浄化装置は、第２保持部に接続されて、第２処理液に電解質を提供する電解質提供部をさらに備えてもよい。濾過部における濾過処理によれば、被処理液に含まれる電解質も第１処理液側へ移動する。そこで、電解質提供部によれば、第２処理液に電解質を提供することにより、第２処理液の電解質量を所望の値に補正することができる。   The blood purification apparatus according to an aspect may further include an electrolyte providing unit that is connected to the second holding unit and provides an electrolyte to the second processing liquid. According to the filtration process in the filtration unit, the electrolyte contained in the liquid to be treated also moves to the first treatment liquid side. Therefore, according to the electrolyte providing unit, the electrolytic mass of the second processing liquid can be corrected to a desired value by providing the electrolyte to the second processing liquid.

一形態に係る血液浄化装置は、濾過部の受入部に接続されて、被処理液に対して圧力を提供するポンプをさらに備えてもよい。この構成によれば、濾過部における濾過処理に要する圧力を確実に提供することが可能になる。従って、血圧が相対的に低い静脈から採取された被処理液を好適に処理することができる。   The blood purification apparatus according to an embodiment may further include a pump that is connected to the receiving unit of the filtration unit and provides pressure to the liquid to be processed. According to this configuration, it is possible to reliably provide the pressure required for the filtration process in the filtration unit. Therefore, the liquid to be processed collected from a vein having a relatively low blood pressure can be suitably processed.

本発明に係る血液浄化装置によれば、患者のクオリティーオブライフ（ＱＯＬ）を向上させることができる。   According to the blood purification apparatus according to the present invention, the quality of life (QOL) of a patient can be improved.

図１は、本実施形態に係る血液浄化装置の構成を示す概略図である。FIG. 1 is a schematic diagram showing the configuration of the blood purification apparatus according to the present embodiment.

以下、添付図面を参照しながら本発明を実施するための形態を詳細に説明する。図面の説明において同一の要素には同一の符号を付し、重複する説明を省略する。   DESCRIPTION OF EMBODIMENTS Hereinafter, embodiments for carrying out the present invention will be described in detail with reference to the accompanying drawings. In the description of the drawings, the same elements are denoted by the same reference numerals, and redundant description is omitted.

図１に示されるように、本実施形態に係る血液浄化装置１は、被処理液である被処理血液Ｂ１に含まれている老廃物Ａ（除去対象成分、図１における黒塗りの四角形を参照）を取り除く。被処理血液Ｂ１から老廃物Ａを取り除く処理を浄化処理と呼ぶ。この浄化処理により、血液浄化装置１は、浄化血液Ｂ４と、人口尿Ｕ（排液）とを生成する。被処理液は、被処理血液Ｂ１だけでなく被処理血液Ｂ１を含む液体であってもよい。以下の説明においては、被処理液の例として被処理血液Ｂ１を例に説明する。   As shown in FIG. 1, the blood purification apparatus 1 according to the present embodiment refers to the waste A (component to be removed, black square in FIG. 1) contained in the blood to be treated B1 that is the liquid to be treated. ) Is removed. The process of removing the waste product A from the blood to be processed B1 is called a purification process. By this purification process, blood purification apparatus 1 generates purified blood B4 and artificial urine U (drainage). The liquid to be processed may be a liquid containing not only the blood to be processed B1 but also the blood to be processed B1. In the following description, the blood to be processed B1 will be described as an example of the liquid to be processed.

血液浄化装置１は、血液導入部１ａと、血液排出部１ｂと、人口尿排出部１ｃとを有する。血液浄化装置１は、被処理血液Ｂ１を血液導入部１ａから取り入れて、浄化処理する。血液導入部１ａは、カテーテルを介して患者１００に接続される。具体的には、血液導入部１ａは、患者１００の血管もしくはバスキュラーアクセスに接続される。血液浄化装置１は、浄化処理によって得られた浄化血液Ｂ４を血液排出部１ｂから排出する。血液排出部１ｂは、カテーテルを介して患者１００に接続される。血液浄化装置１は、浄化処理によって得られた人口尿Ｕを人口尿排出部１ｃから排出する。   The blood purification apparatus 1 has a blood introduction part 1a, a blood discharge part 1b, and an artificial urine discharge part 1c. The blood purification apparatus 1 takes in the blood to be processed B1 from the blood introduction part 1a and purifies it. The blood introduction part 1a is connected to the patient 100 via a catheter. Specifically, the blood introduction part 1a is connected to the blood vessel or vascular access of the patient 100. The blood purification apparatus 1 discharges the purified blood B4 obtained by the purification process from the blood discharge part 1b. The blood discharge part 1b is connected to the patient 100 via a catheter. The blood purification apparatus 1 discharges the artificial urine U obtained by the purification process from the artificial urine discharge part 1c.

血液浄化装置１は、主要な構成要素として、ポンプ２と、濾過部３と、再吸収部４と、電解質提供部５とを有する。   The blood purification apparatus 1 includes a pump 2, a filtration unit 3, a reabsorption unit 4, and an electrolyte providing unit 5 as main components.

いわゆる血液ポンプであるポンプ２は、血液導入部１ａと、濾過部３とに接続される。ポンプ２は、濾過部３における限外濾過処理に要する圧力を発生させる。なお、患者１００の動脈から被処理血液Ｂ１を取り出すような場合、限外濾過処理に要する圧力は、患者１００の動脈における血圧（例えば１００ｍＨｇ）により足りることがある。その場合には、ポンプ２は、省略してもよい。   A pump 2 that is a so-called blood pump is connected to the blood introduction part 1 a and the filtration part 3. The pump 2 generates a pressure required for the ultrafiltration process in the filtration unit 3. When blood B1 to be processed is taken out from the artery of the patient 100, the pressure required for the ultrafiltration process may be sufficient due to the blood pressure (for example, 100 mHg) in the artery of the patient 100. In that case, the pump 2 may be omitted.

濾過部３は、ポンプ２と、再吸収部４とに接続される。濾過部３は、老廃物Ａを含む被処理血液Ｂ１を受け入れて、限外濾過によって希薄血液Ｂ２（第１処理液）と、濃縮血液Ｂ３（第２処理液）をそれぞれ生成する。ここで、老廃物Ａには、例えば、尿素、窒素、クレアチニン等が挙げられる。また、血液成分ＢＣには、例えば、白血球、赤血球、アルブミン、血小板等が挙げられる。さらに、希薄血液Ｂ２とは、老廃物Ａ及び電解質Ｅ（図１における黒塗りの三角形を参照）を含み且つ血液成分ＢＣを含まない液体をいい、濃縮血液Ｂ３は血液成分ＢＣを含む液体をいう。なお、濃縮血液Ｂ３は、老廃物Ａや電解質Ｅを含んでいてもよい。要するに、濃縮血液Ｂ３は、被処理血液Ｂ１よりも少ない老廃物Ａを含み得る。   The filtration unit 3 is connected to the pump 2 and the reabsorption unit 4. The filtration part 3 receives the to-be-processed blood B1 containing the waste A, and produces | generates the diluted blood B2 (1st process liquid) and the concentrated blood B3 (2nd process liquid) by ultrafiltration, respectively. Here, examples of the waste A include urea, nitrogen, creatinine, and the like. Examples of the blood component BC include white blood cells, red blood cells, albumin, and platelets. Further, the dilute blood B2 refers to a liquid that contains the waste product A and the electrolyte E (see the black triangles in FIG. 1) and does not include the blood component BC, and the concentrated blood B3 refers to a liquid that includes the blood component BC. . Note that the concentrated blood B3 may contain waste products A and electrolytes E. In short, the concentrated blood B3 may contain less waste A than the blood to be processed B1.

濾過部３は、第１受入部３ａと、第１領域３ｂと、第２領域３ｃと、希薄血液Ｂ２を排出する第１排出部３ｄと、濃縮血液Ｂ３を排出する第２排出部３ｅと、第１処理膜６と、を有する。第１受入部３ａは、ポンプ２に接続されて、所定の圧力を有する被処理血液Ｂ１を受け入れる。第１受入部３ａは、第１領域３ｂの入り口であり、第２排出部３ｅは、第１領域３ｂの出口に対応する。つまり、第２排出部３ｅは、濃縮血液Ｂ３を排出する。第１処理膜６は、第１受入部３ａと第１排出部３ｄとを隔てるように配置される。つまり、第１受入部３ａと第２排出部３ｅとの間を隔てる構成物は存在しないが、第１受入部３ａと第１排出部３ｄとを隔てる構成物（第１処理膜６）が存在する。   The filtration unit 3 includes a first receiving unit 3a, a first region 3b, a second region 3c, a first discharge unit 3d that discharges the diluted blood B2, a second discharge unit 3e that discharges the concentrated blood B3, A first treatment film 6. The 1st receiving part 3a is connected to the pump 2, and receives the to-be-processed blood B1 which has a predetermined pressure. The 1st receiving part 3a is an entrance of the 1st field 3b, and the 2nd discharge part 3e respond | corresponds to the exit of the 1st field 3b. That is, the second discharge part 3e discharges the concentrated blood B3. The 1st process film | membrane 6 is arrange | positioned so that the 1st receiving part 3a and the 1st discharge part 3d may be separated. That is, there is no component that separates the first receiving portion 3a and the second discharge portion 3e, but there is a component that separates the first receiving portion 3a and the first discharge portion 3d (first treatment film 6). To do.

第１処理膜６は、血液成分ＢＣより小さい第１細孔６ａを有し、血液成分ＢＣより小さい老廃物Ａを通過させる。換言すると、第１処理膜６は、血液成分ＢＣ（例えば、アルブミン）を通過させない。このような処理膜として、例えば、ＨＤ（Ｈｅｍｏｄｉａｌｙｓｉｓ）膜やＨＦ（ｈｅｍｏｆｉｌｔｒａｔｉｏｎ）膜が挙げられる。第１細孔６ａの大きさは、例えば分画分子量６６，０００（アルブミン分子量）以下の大きさとすることができる。分画分子量とは使用する膜が対象分子の通過を阻止できる分子量の目安である。また、アルブミンは人工透析での漏洩を抑えたい有用タンパク質であり、分画分子量６６，０００は細孔径の最大値である。また、濾過部３の構成は、いわゆるダイアライザーの構成を採用してもよい。この場合には、濾過部３は、第１処理膜６としてＨＤ膜やＨＦ膜により形成される複数の中空糸膜を有する。中空糸膜の特性である膜透過率は、圧力と分離率により決定できる。   The first treatment membrane 6 has first pores 6a smaller than the blood component BC, and allows the waste product A smaller than the blood component BC to pass therethrough. In other words, the first treatment film 6 does not allow blood components BC (eg, albumin) to pass through. Examples of such a treatment film include an HD (Hemodialysis) film and an HF (hemofiltration) film. The size of the first pore 6a can be, for example, a size equal to or less than the fractional molecular weight 66,000 (albumin molecular weight). The molecular weight cut off is a measure of the molecular weight that the membrane to be used can block the passage of the target molecule. Albumin is a useful protein that is desired to suppress leakage during artificial dialysis, and the molecular weight cut off is 66,000, which is the maximum pore size. Moreover, you may employ | adopt the structure of what is called a dialyzer as the structure of the filtration part 3. FIG. In this case, the filtration unit 3 has a plurality of hollow fiber membranes formed of HD membranes or HF membranes as the first treatment membrane 6. The membrane permeability, which is a characteristic of the hollow fiber membrane, can be determined by the pressure and the separation rate.

再吸収部４は、希薄血液Ｂ２及び濃縮血液Ｂ３をそれぞれ受け入れて、希薄血液Ｂ２が含む水分を濃縮血液Ｂ３に吸収させる。この吸収により、希薄血液Ｂ２を人口尿Ｕへ変化させると共に、濃縮血液Ｂ３を浄化血液Ｂ４に変化させる。つまり、再吸収部４は、水分が減少した希薄血液Ｂ２を人口尿Ｕとして排出すると共に、水分を吸収した濃縮血液Ｂ３を浄化血液Ｂ４として排出する。この人口尿Ｕは、濃縮された老廃物Ａと電解質Ｅと水分とを含む。   The reabsorption unit 4 receives the diluted blood B2 and the concentrated blood B3, respectively, and causes the concentrated blood B3 to absorb the water contained in the diluted blood B2. By this absorption, the diluted blood B2 is changed to artificial urine U, and the concentrated blood B3 is changed to purified blood B4. That is, the reabsorption unit 4 discharges the diluted blood B2 with reduced water as artificial urine U, and discharges the concentrated blood B3 that has absorbed water as purified blood B4. The artificial urine U contains concentrated waste products A, electrolytes E, and moisture.

再吸収部４は、希薄血液Ｂ２を保持する第１保持部７と、濃縮血液Ｂ３を保持する第２保持部８と、第２処理膜９と、有する。第１保持部７は、第２受入部７ａと、第３排出部７ｂとを有し、第２受入部７ａから希薄血液Ｂ２を受け入れて、第３排出部７ｂから人口尿Ｕを排出する。第２保持部８は、第３受入部８ａと第４排出部８ｂとを有し、第３受入部８ａから濃縮血液Ｂ３を受け入れて、第４排出部８ｂから浄化血液Ｂ４を排出する。第２処理膜９は、第１保持部７と第２保持部８とを隔てるように配置される。第２処理膜９は、いわゆる逆浸透膜（ＲＯ（Ｒｅｖｅｒｓｅ Ｏｓｍｏｓｉｓ）膜）である。第２処理膜９は、老廃物Ａよりも小さい第２細孔９ａを有する。例えば、第２処理膜９は、水は透過するが、尿素といった水以外の物質は透過しない。従って、第２処理膜９の第２細孔９ａは、第１処理膜６の第１細孔６ａよりも小さい。第２細孔９ａの大きさは、例えば分画分子量が２０〜１００程度とすることができる。   The reabsorption unit 4 includes a first holding unit 7 that holds the diluted blood B2, a second holding unit 8 that holds the concentrated blood B3, and a second treatment film 9. The 1st holding | maintenance part 7 has the 2nd receiving part 7a and the 3rd discharge part 7b, receives the diluted blood B2 from the 2nd receiving part 7a, and discharges the artificial urine U from the 3rd discharge part 7b. The second holding unit 8 includes a third receiving unit 8a and a fourth discharging unit 8b, receives the concentrated blood B3 from the third receiving unit 8a, and discharges the purified blood B4 from the fourth discharging unit 8b. The second treatment film 9 is disposed so as to separate the first holding unit 7 and the second holding unit 8. The second treatment membrane 9 is a so-called reverse osmosis membrane (RO (Reverse Osmosis) membrane). The second treatment film 9 has second pores 9a smaller than the waste product A. For example, the second treatment film 9 transmits water but does not transmit substances other than water such as urea. Therefore, the second pore 9 a of the second treatment film 9 is smaller than the first pore 6 a of the first treatment film 6. As for the size of the second pore 9a, for example, the fractional molecular weight can be about 20 to 100.

ここで、濾過部３における濾過処理にあっては、老廃物Ａと共に電解質Ｅも水分と共に希薄血液Ｂ２側へ移動する。つまり、濃縮血液Ｂ３の電解質Ｅの量は、患者１００から取り出された直後の被処理血液Ｂ１の電解質Ｅの量と異なる。具体的には、濃縮血液Ｂ３の電解質Ｅの量は、被処理血液Ｂ１の電解質Ｅの量より少ない。そこで、電解質提供部５は、濃縮血液Ｂ３に電解質Ｅを提供することにより補正を行う。具体的には、電解質提供部５は、例えば、ナトリウムイオンＮａ＋、クロールイオンＣｌ−、重炭酸イオンＨＣｏ３ −といった電解質Ｅを保持する。そして、電解質提供部５は、濃縮血液Ｂ３における電解質Ｅの量に応じて、濃縮血液Ｂ３に電解質Ｅを提供する。電解質提供部５は、例えば、第２保持部８の第４受入部８ｃを介して、第２保持部８に接続される。 Here, in the filtration process in the filtration part 3, the waste E and the electrolyte E move to the diluted blood B2 side together with moisture. That is, the amount of the electrolyte E in the concentrated blood B3 is different from the amount of the electrolyte E in the blood to be treated B1 immediately after being removed from the patient 100. Specifically, the amount of the electrolyte E in the concentrated blood B3 is smaller than the amount of the electrolyte E in the blood to be treated B1. Therefore, the electrolyte providing unit 5 performs correction by providing the electrolyte E to the concentrated blood B3. Specifically, the electrolyte providing unit 5 holds an electrolyte E such as sodium ions Na + , chlor ions Cl − , and bicarbonate ions HCo 3 − . Then, the electrolyte providing unit 5 provides the electrolyte E to the concentrated blood B3 according to the amount of the electrolyte E in the concentrated blood B3. The electrolyte providing unit 5 is connected to the second holding unit 8 via, for example, the fourth receiving unit 8 c of the second holding unit 8.

以下、本実施形態に係る血液浄化装置１の動作について説明する。血液浄化装置１は、濾過処理と再吸収処理とを利用して、被処理血液Ｂ１を浄化する。   Hereinafter, the operation of the blood purification apparatus 1 according to the present embodiment will be described. The blood purification apparatus 1 purifies the blood to be treated B1 using a filtration process and a reabsorption process.

患者１００から取り出された被処理血液Ｂ１は、まず、濾過処理に付される。濾過処理では、老廃物Ａを水分と共に被処理血液Ｂ１から取り出す。具体的には、第１処理膜６は、血液成分ＢＣより小さい第１細孔６ａを有する。従って、水分と老廃物Ａとは第１細孔６ａを通過する。一方、血液成分ＢＣは、第１細孔６ａを通過できない。   The blood to be processed B1 taken out from the patient 100 is first subjected to a filtration process. In the filtration treatment, the waste product A is taken out from the blood to be treated B1 together with moisture. Specifically, the first treatment film 6 has first pores 6a smaller than the blood component BC. Accordingly, the moisture and the waste product A pass through the first pore 6a. On the other hand, the blood component BC cannot pass through the first pore 6a.

濾過処理によれば、血液成分ＢＣを含まない血液（つまり希薄血液）と、血液成分ＢＣを含む血液（つまり濃縮血液）とが得られる。本実施形態でいう「希薄」及び「濃縮」は、水分量に対する血液成分ＢＣの量に基づく。つまり、「希薄血液」は、単位量あたりの血液成分ＢＣの量が被処理血液Ｂ１よりよりも少ない点で、血液成分ＢＣが「希薄」である。一方、「濃縮血液」は、単位量あたりの血液成分ＢＣの量が被処理血液よりも多い点で、血液成分ＢＣが「濃縮」されている。なお、老廃物Ａが水と共に移動するので、希薄血液Ｂ２における老廃物Ａの濃度は、濃縮血液Ｂ３における老廃物Ａの濃度と同じである。希薄血液Ｂ２における老廃物Ａの量は、移動した水の量で決まる。ただし、血液成分ＢＣの量は、希薄血液Ｂ２よりも濃縮血液Ｂ３が多い。   According to the filtration treatment, blood containing no blood component BC (ie, diluted blood) and blood containing the blood component BC (ie, concentrated blood) are obtained. “Dilute” and “concentration” in this embodiment are based on the amount of blood component BC relative to the amount of water. That is, “diluted blood” is a “diluted” blood component BC in that the amount of blood component BC per unit amount is smaller than the blood to be treated B1. On the other hand, “concentrated blood” is “concentrated” in blood component BC in that the amount of blood component BC per unit amount is larger than that of blood to be treated. Since the waste product A moves together with water, the concentration of the waste product A in the diluted blood B2 is the same as the concentration of the waste product A in the concentrated blood B3. The amount of waste A in the diluted blood B2 is determined by the amount of water that has moved. However, the amount of the blood component BC is greater in the concentrated blood B3 than in the diluted blood B2.

上記の濾過処理によって、被処理血液Ｂ１から老廃物Ａが取り除かれる。しかし、濃縮血液Ｂ３は、単位量あたりの被処理血液Ｂ１に比べて血液成分ＢＣの量が多い。従って、患者１００に返血するためには、血液成分ＢＣの量を所定の範囲に調整する必要がある。つまり、濃縮血液Ｂ３に水分を提供する。そして、濃縮血液Ｂ３に提供される水分は、希薄血液Ｂ２から得る。つまり、老廃物Ａと共に取り出された水分を、再び濃縮血液Ｂ３に戻す。従って、この処理を、「再吸収」と呼ぶ。   By the above filtration treatment, the waste A is removed from the blood to be treated B1. However, the concentrated blood B3 has a larger amount of blood component BC than the blood to be processed B1 per unit amount. Therefore, in order to return blood to the patient 100, it is necessary to adjust the amount of the blood component BC to a predetermined range. That is, water is provided to the concentrated blood B3. The water provided to the concentrated blood B3 is obtained from the diluted blood B2. That is, the water taken out together with the waste product A is returned again to the concentrated blood B3. Therefore, this process is called “re-absorption”.

この水分の再吸収は、逆浸透現象を利用する。希薄血液Ｂ２と濃縮血液Ｂ３とを第２処理膜９によって隔てると、その浸透圧差は、例えば７×１０５Ｐａ（約７気圧）程度にも達する。つまり、濃縮血液Ｂ３は、希薄血液Ｂ２から水分を引き込む力を発生させ得る。従って、希薄血液Ｂ２の浸透圧と濃縮血液Ｂ３との浸透圧との差異に起因して、希薄血液Ｂ２から濃縮血液Ｂ３へ水の移動が生じる。この水の移動は、例えば、第２細孔９ａの細孔径（分画分子量）と分離率（濾過比）により変化する。また、浸透圧は、濃縮血液Ｂ３における血液成分ＢＣのモル濃度に比例する。希薄血液Ｂ２の浸透圧と濃縮血液Ｂ３の浸透圧とが略等価（浸透圧平衡状態）になるまで、希薄血液Ｂ２から濃縮血液Ｂ３へ水の移動が継続する。なお、上記約７気圧とは、第１処理膜で電解質を全く透過させなかった場合の最大値である。また、第１処理膜で水分が半分になり、当該水分に含まれていた電解質Ｅの補正を行うと場合は３．５×１０５Ｐａ（約３．５気圧）になる。３．５気圧でも７気圧でも十分に再吸収をすることができる。 This reabsorption of moisture utilizes the reverse osmosis phenomenon. When the diluted blood B2 and the concentrated blood B3 are separated by the second treatment membrane 9, the osmotic pressure difference reaches, for example, about 7 × 10 5 Pa (about 7 atm). That is, the concentrated blood B3 can generate a force that draws moisture from the diluted blood B2. Therefore, due to the difference between the osmotic pressure of the diluted blood B2 and the osmotic pressure of the concentrated blood B3, water moves from the diluted blood B2 to the concentrated blood B3. This movement of water varies depending on, for example, the pore diameter (fractionated molecular weight) of the second pores 9a and the separation rate (filtration ratio). The osmotic pressure is proportional to the molar concentration of blood component BC in the concentrated blood B3. The movement of water from the diluted blood B2 to the concentrated blood B3 continues until the osmotic pressure of the diluted blood B2 and the osmotic pressure of the concentrated blood B3 become substantially equivalent (osmotic pressure equilibrium state). The above-mentioned about 7 atm is the maximum value when no electrolyte is permeated through the first treatment film. In addition, when the first treatment film halves moisture, and correction of the electrolyte E contained in the moisture is performed, the pressure becomes 3.5 × 10 5 Pa (about 3.5 atm). Sufficient reabsorption is possible at either 3.5 atm or 7 atm.

血液浄化装置１は、従来の血液浄化装置（すなわち人工透析装置）が利用する、「拡散現象」を利用することなく、被処理血液Ｂ１から老廃物Ａを取り除く。この浄化処理は、互いに異なる特性を有する２種類の人工膜（第１処理膜６及び第２処理膜９）により実現される。従って、血液浄化装置１は、「拡散現象」を利用する装置では、必須の要素である「透析液」を備える必要が無い。このため、血液浄化装置１は、従来の血液浄化装置と比較すると、大幅な小型化及び軽量化が可能であり、患者１００が持ち運べる程度の大きさにまでコンパクト化することができる。そうすると、患者１００に課される時間や場所といった拘束が著しく低減されるので、患者１００のクオリティーオブライフ（ＱＯＬ）を向上させることができる。   The blood purification apparatus 1 removes the waste A from the blood to be treated B1 without using the “diffusion phenomenon” used by the conventional blood purification apparatus (that is, the artificial dialysis apparatus). This purification treatment is realized by two types of artificial membranes (first treatment membrane 6 and second treatment membrane 9) having different characteristics. Therefore, the blood purification apparatus 1 does not need to be provided with “dialysis fluid” which is an essential element in an apparatus using the “diffusion phenomenon”. For this reason, the blood purification apparatus 1 can be significantly reduced in size and weight as compared with the conventional blood purification apparatus, and can be downsized to a size that the patient 100 can carry. As a result, constraints such as time and place imposed on the patient 100 are significantly reduced, so that the quality of life (QOL) of the patient 100 can be improved.

換言すると、血液浄化装置１は、濾過部３において希薄血液Ｂ２を生成する。この希薄血液Ｂ２には、除去されるべき成分が含まれる。そうすると、濃縮血液Ｂ３における老廃物Ａの量は、被処理血液Ｂ１における老廃物Ａの量に比べて少なくなる。次に、血液浄化装置１は、再吸収部４において、希薄血液Ｂ２中の水分を濃縮血液Ｂ３に吸収させる。この吸収により、濃縮血液Ｂ３における血液成分ＢＣの量が被処理血液Ｂ１と等価である浄化血液Ｂ４が得られる。この浄化血液Ｂ４は、老廃物Ａの量が被処理血液Ｂ１よりも少ないので、被処理血液Ｂ１が浄化されたことになる。上述したように、血液浄化装置１は、拡散現象を利用することなく被処理血液Ｂ１から老廃物Ａが取り除かれた浄化血液Ｂ４を得ることができる。そうすると、血液浄化装置１は、透析液を必要としないので、患者１００が携帯可能な大きさまで小型化及び軽量化が可能である。従って、定期的な通院や長時間の拘束を要しなくなるので、患者１００の負担を軽減することができる。ひいては、血液浄化装置１は患者１００のクオリティーオブライフ（ＱＯＬ）を向上させることができる。   In other words, the blood purification apparatus 1 generates the diluted blood B2 in the filtration unit 3. This diluted blood B2 contains components to be removed. Then, the amount of the waste product A in the concentrated blood B3 becomes smaller than the amount of the waste product A in the blood to be treated B1. Next, the blood purification apparatus 1 causes the concentrated blood B3 to absorb the water in the diluted blood B2 in the reabsorption unit 4. By this absorption, purified blood B4 in which the amount of blood component BC in the concentrated blood B3 is equivalent to the blood to be processed B1 is obtained. In this purified blood B4, the amount of waste A is less than the blood to be processed B1, and thus the blood to be processed B1 has been purified. As described above, the blood purification apparatus 1 can obtain the purified blood B4 from which the waste product A is removed from the blood to be processed B1 without using the diffusion phenomenon. Then, since the blood purification apparatus 1 does not require dialysate, it can be reduced in size and weight to a size that can be carried by the patient 100. Therefore, since regular hospital visits and long-term restraint are not required, the burden on the patient 100 can be reduced. As a result, the blood purification apparatus 1 can improve the quality of life (QOL) of the patient 100.

血液浄化装置１は、第１受入部３ａから濾過部３へ被処理血液Ｂ１を受け入れる。受け入れられた被処理血液Ｂ１は、第１処理膜６を通過して希薄血液Ｂ２となる。この第１処理膜６は、血液成分ＢＣより小さい第１細孔６ａを有する。従って、希薄血液Ｂ２は、血液成分ＢＣより小さい老廃物Ａと水分とを含む。従って、濾過部３によって、被処理血液Ｂ１から濃縮血液Ｂ３が得られる。次に、希薄血液Ｂ２と濃縮血液Ｂ３は、再吸収部４に送られる。再吸収部４は、第１保持部７における希薄血液Ｂ２と第２保持部８における希薄血液Ｂ２とを第２処理膜９によって隔てる。第２処理膜９は、水は透過するが、尿素といった水以外の物質は透過しない第２細孔９ａを有する。そうすると、希薄血液Ｂ２と濃縮血液Ｂ３との浸透圧差に起因して、第１保持部７における希薄血液Ｂ２から第２保持部８における濃縮血液Ｂ３への水分の移動が浸透圧差がなくなるまで継続する。この水分の移動により、濃縮血液Ｂ３から浄化血液Ｂ４が得ることができる。   The blood purification apparatus 1 receives the blood B1 to be processed from the first receiving unit 3a to the filtering unit 3. The received blood to be treated B1 passes through the first treatment membrane 6 and becomes a diluted blood B2. The first treatment film 6 has first pores 6a that are smaller than the blood component BC. Therefore, the diluted blood B2 contains waste products A and water smaller than the blood component BC. Therefore, the filtering unit 3 obtains the concentrated blood B3 from the blood to be processed B1. Next, the diluted blood B2 and the concentrated blood B3 are sent to the reabsorption unit 4. The reabsorption unit 4 separates the diluted blood B2 in the first holding unit 7 and the diluted blood B2 in the second holding unit 8 by the second treatment film 9. The second treatment film 9 has second pores 9a that allow water to pass through but do not pass substances other than water such as urea. Then, due to the osmotic pressure difference between the diluted blood B2 and the concentrated blood B3, the movement of water from the diluted blood B2 in the first holding unit 7 to the concentrated blood B3 in the second holding unit 8 continues until there is no osmotic pressure difference. . Purified blood B4 can be obtained from the concentrated blood B3 by this movement of moisture.

また、血液浄化装置１は、患者１００が持ち運び可能な程度にコンパクトであるので、継続的な血液浄化処理を行うことが可能になる。このため、血液浄化装置１は、一回の血液浄化サイクルで全ての老廃物Ａを取り除くという能力は要求されない。従って、また、継続的な適用によれば、単位時間あたりに患者１００から被処理血液Ｂ１を取り出す血液量を少なくすることが可能になる。そうすると、患者１００に与える身体的な負担を軽減できる。   Moreover, since the blood purification apparatus 1 is compact enough to be carried by the patient 100, it is possible to perform continuous blood purification processing. For this reason, the blood purification apparatus 1 is not required to have the ability to remove all the waste A in one blood purification cycle. Therefore, according to the continuous application, it is possible to reduce the amount of blood to be extracted from the patient 100 per unit time. Then, the physical burden given to the patient 100 can be reduced.

例えば、従来の人工透析装置を利用する場合には、所望の血流量を得るためにシャントを用いる。しかし、本実施形態に係る血液浄化装置１は、従来の人工透析装置に比べて単位時間当たりの血流量が少なくてよいので、シャントを用いる必要が無い。従って、患者１００の身体的負担を大きく軽減できる。   For example, when using a conventional artificial dialysis device, a shunt is used to obtain a desired blood flow rate. However, the blood purification apparatus 1 according to the present embodiment does not need to use a shunt because the blood flow per unit time may be smaller than that of a conventional artificial dialysis apparatus. Therefore, the physical burden on the patient 100 can be greatly reduced.

以上、本発明をその実施形態に基づいて詳細に説明した。しかし、本発明は上記実施形態に限定されるものではない。本発明は、その要旨を逸脱しない範囲で様々な変形が可能である。   The present invention has been described in detail based on the embodiments. However, the present invention is not limited to the above embodiment. The present invention can be variously modified without departing from the gist thereof.

例えば、血液浄化装置１は、被処理血液Ｂ１に対して血液抗凝固剤を提供する血液抗凝固剤提供部を備えていてもよい。また、血液浄化装置１は、濾過部３と再吸収部４との間に配置されたポンプやバルブを有してもよい。さらに、血液浄化装置１は、再吸収部４よりも下流側に配置されたポンプやバルブを有してもよい。   For example, the blood purification apparatus 1 may include a blood anticoagulant providing unit that provides a blood anticoagulant to the blood to be processed B1. Moreover, the blood purification apparatus 1 may have a pump or a valve disposed between the filtration unit 3 and the reabsorption unit 4. Furthermore, the blood purification apparatus 1 may have a pump or a valve disposed on the downstream side of the reabsorption unit 4.

例えば、第１処理膜の例として、ＨＤ膜又はＨＦ膜を例示した。しかし、第１処理膜はこれらの人工膜に限定されない。第１処理膜は、老廃物Ａを透過し且つ血液成分ＢＣを透過させない特性を有するものであれば、種々の膜を用いてよい。また、第２処理膜の例として、ＲＯ膜を例示した。しかし、第２処理膜はこの人工膜に限定されない。第２処理膜は、水分を透過し且つ老廃物Ａ等を透過させない特性を有するものであれば、種々の膜を用いてよい。   For example, an HD film or an HF film is illustrated as an example of the first treatment film. However, the first treatment film is not limited to these artificial films. As long as the 1st process film | membrane has the characteristic which permeate | transmits the waste material A and does not permeate | transmit the blood component BC, you may use a various film | membrane. Moreover, the RO film | membrane was illustrated as an example of a 2nd process film | membrane. However, the second treatment film is not limited to this artificial film. As the second treatment film, various films may be used as long as they have characteristics of allowing moisture to permeate but not allowing waste A or the like to permeate.

１…血液浄化装置、１ａ…血液導入部、１ｂ…血液排出部、１ｃ…人口尿排出部、２…ポンプ、３…濾過部、３ａ…第１受入部、３ｂ…第１領域、３ｃ…第２領域、３ｄ…第１排出部、３ｅ…第２排出部、４…再吸収部、５…電解質提供部、６…第１処理膜、６ａ…第１細孔、７…第１保持部、７ａ…第２受入部、７ｂ…第３排出部、８…第２保持部、８ａ…第３受入部、８ｂ…第４排出部、８ｃ…第４受入部、９…第２処理膜、９ａ…第２細孔、１００…患者、Ａ…老廃物（除去対象成分）、Ｂ１…被処理血液（被処理液）、Ｂ２…希薄血液（第１処理液）、Ｂ３…濃縮血液（第２処理液）、Ｂ４…浄化血液、ＢＣ…血液成分、Ｅ…電解質、Ｕ…人口尿（排液）。 DESCRIPTION OF SYMBOLS 1 ... Blood purification apparatus, 1a ... Blood introduction part, 1b ... Blood discharge | emission part, 1c ... artificial urine discharge part, 2 ... Pump, 3 ... Filtration part, 3a ... 1st receiving part, 3b ... 1st area | region, 3c ... 1st 2 region, 3d ... 1st discharge part, 3e ... 2nd discharge part, 4 ... reabsorption part, 5 ... electrolyte provision part, 6 ... 1st process film, 6a ... 1st pore, 7 ... 1st holding part, 7a ... 2nd receiving part, 7b ... 3rd discharge part, 8 ... 2nd holding | maintenance part, 8a ... 3rd receiving part, 8b ... 4th discharge part, 8c ... 4th receiving part, 9 ... 2nd process film, 9a ... second pore, 100 ... patient, A ... waste (component to be removed), B1 ... blood to be treated (liquid to be treated), B2 ... diluted blood (first treatment liquid), B3 ... concentrated blood (second treatment) Liquid), B4 ... purified blood, BC ... blood component, E ... electrolyte, U ... artificial urine (drainage).

Claims (5)

除去対象成分を含む血液又は前記血液を含む液体である被処理液を受け入れて、限外濾過によって前記被処理液から前記除去対象成分を含み且つ血液成分を含まない第１処理液を生成すると共に前記血液成分を含む第２処理液を生成する濾過部と、
前記第１処理液及び前記第２処理液を受け入れて、前記第１処理液が含む水分を前記第２処理液に吸収させることにより、前記水分が減少した前記第１処理液を排液として排出すると共に前記水分を吸収した前記第２処理液を浄化血液として排出する再吸収部と、を備える、血液浄化装置。 Receiving blood to be removed or liquid to be treated which is a liquid containing blood, and generating a first treatment liquid containing the component to be removed and free of blood component from the liquid to be treated by ultrafiltration A filtration unit for generating a second treatment liquid containing the blood component;
The first treatment liquid and the second treatment liquid are received and the moisture contained in the first treatment liquid is absorbed by the second treatment liquid, whereby the first treatment liquid with the reduced moisture is discharged as a drainage liquid. And a reabsorption part that discharges the second treatment liquid that has absorbed the moisture as purified blood. 前記濾過部は、
前記被処理液を受け入れる受入部と、
前記第１処理液を排出する第１排出部と、
前記第２処理液を排出する第２排出部と、
前記受入部と前記第１排出部とを互いに隔てるように配置された第１処理膜と、を有し、
前記再吸収部は、
前記第１処理液を受け入れて、前記第１処理液を保持する第１保持部と、
前記第２処理液を受け入れて、前記第２処理液を保持する第２保持部と、
前記第１保持部と前記第２保持部とを互いに隔てるように配置された第２処理膜と、有し、
前記第１処理膜は、前記血液成分より小さい第１細孔を有し、前記第１細孔より小さい前記除去対象成分を前記水分と共に通過させ、
前記第２処理膜は、前記除去対象成分よりも小さい第２細孔を有し、前記第２細孔よりも小さい前記水分を通過させる、請求項１に記載の血液浄化装置。 The filtration unit is
A receiving part for receiving the liquid to be treated;
A first discharger for discharging the first treatment liquid;
A second discharger for discharging the second treatment liquid;
A first treatment film disposed so as to separate the receiving part and the first discharge part from each other;
The reabsorber is
A first holding unit that receives the first processing liquid and holds the first processing liquid;
A second holding unit that receives the second processing liquid and holds the second processing liquid;
A second treatment film arranged to separate the first holding part and the second holding part from each other;
The first treatment membrane has first pores smaller than the blood component, and allows the removal target component smaller than the first pore to pass along with the moisture,
The blood purification apparatus according to claim 1, wherein the second treatment film has second pores smaller than the component to be removed and allows the moisture smaller than the second pores to pass therethrough. 前記第１処理膜の分画分子量は６６，０００以下であり、かつ、前記第２処理膜の分画分子量は２０以上１００以下である請求項２に記載の血液浄化装置。   The blood purification apparatus according to claim 2, wherein the fractionated molecular weight of the first treatment membrane is 66,000 or less, and the fractionation molecular weight of the second treatment membrane is 20 or more and 100 or less. 前記第２保持部に接続されて、前記第２処理液に電解質を提供する電解質提供部をさらに備える、請求項２又は３に記載の血液浄化装置。   The blood purification apparatus according to claim 2 or 3, further comprising an electrolyte providing unit connected to the second holding unit and providing an electrolyte to the second processing liquid. 前記濾過部の前記受入部に接続されて、前記被処理液に対して圧力を提供するポンプをさらに備える、請求項２〜４の何れか一項に記載の血液浄化装置。   The blood purification apparatus according to any one of claims 2 to 4, further comprising a pump connected to the receiving unit of the filtration unit and providing a pressure to the liquid to be processed.
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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS55122561A (en) * 1979-03-15 1980-09-20 Daicel Ltd Sealing system filtration type artificial kidney
JPS6113967A (en) * 1984-06-29 1986-01-22 堀口　幸夫 Artificial kidney apparatus
JPH03502647A (en) * 1987-10-23 1991-06-20 ３アイ　リサーチ　エクスプロイテーション　リミテッド blood purification device
JP2002528241A (en) * 1998-10-30 2002-09-03 ネフロス・インコーポレーテッド Permeation type filtration system by osmotic pressure difference
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