JPH0531183A - Hemodialyzer - Google Patents

Abstract

PURPOSE:To achieve higher water removing accuracy with a simple construction by providing flowmeters, respectively on a blood inflow path and a blood outflow path to control a flow rate of a constant amount pump provided on the dialysis solution supply path and dialysis solution drain path, depending on a difference of a flow rate measured by the individual flowmeters. CONSTITUTION:Constant amount pumps 18 and 19 are provided respectively on a dialysis solution supply path 9 and a dialysis drain path 8 to be controlled independently with a control section 15. The constant amount pump 19 is fixed and operated at a fixed number of revolutions corresponding to a flow rate preset. Then, when blood is supplied to a dialyzer 1 at a fixed flow rate with a blood pump 5, flowmeters 16 and 17, provided respectively on a blood inflow path 6 and a blood outflow path 7, detect blood flow rates of the paths 6 and 7 to send information to the control section 15. Then, the control section 15 determines a difference in flow rate between the flowmeters 16 and 17, namely, an amount of water to be removed per unit time to control the number of revolutions of the constant amount pump 18 on the side of the dialysis drain path 8 so that the amount of water to be removed corresponds to a preset value.

Description

【発明の詳細な説明】Detailed Description of the Invention

【０００１】[0001]

【産業上の利用分野】本発明は腎不全患者の治療に用い
られる血液透析装置に関し、特に血液中の水分を正確に
除去する血液透析装置に関する。BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a hemodialysis apparatus used for treating a patient with renal failure, and more particularly to a hemodialysis apparatus for accurately removing water in blood.

【０００２】[0002]

【従来の技術】血液透析装置は腎不全患者の治療を行な
う装置として広く普及している。透析療法は単に血液中
の老廃物を除去するだけでなく、尿の出ない透析患者か
ら飲食した水分をも除去するいわゆる除水の役割を果た
しているが、この除水の制御を誤れば患者の生命に危険
を及ぼすこととなるため、血液透析装置には厳しい除水
制御性能が要求される。2. Description of the Related Art Hemodialysis devices are widely used as devices for treating patients with renal failure. Dialysis therapy not only removes waste products in the blood but also removes water consumed by dialysis patients who do not produce urine. Since it is life-threatening, the hemodialysis device is required to have strict water removal control performance.

【０００３】除水の制御を行なうために従来は透析器内
の浸透性半透膜で隔たれた血液流路と透析液流路の圧力
差すなわち限外濾過圧を絞り弁等で調整していたが、近
年透析器が高性能化し除水能が向上したため小さな限外
濾過圧で多量の除水が可能となり限外濾過圧の調整では
十分な除水量の調整が困難となった。そこで現在では透
析液の透析器への流入量と透析器からの流出量を調節す
ることにより除水量を制御する方法が主流となってい
る。その例を以下に示す。In order to control the water removal, the pressure difference between the blood flow path and the dialysate flow path separated by the permeable semipermeable membrane in the dialyzer, that is, the ultrafiltration pressure, has conventionally been adjusted by a throttle valve or the like. However, in recent years, since the dialysis machine has improved in performance and improved in water removal capacity, a large amount of water can be removed with a small ultrafiltration pressure, and it becomes difficult to adjust a sufficient amount of water removal by adjusting the ultrafiltration pressure. Therefore, at present, the mainstream method is to control the amount of water removed by adjusting the inflow amount of the dialysate into the dialyzer and the outflow amount of the dialyzer. An example is shown below.

【０００４】図２、図３は透析器１に流入する透析液流
量と透析器から流出する透析液流量を等しくする複式ポ
ンプを用いて透析液の等流量回路を構成し、透析排液路
側に除水用定量ポンプ４を設けることにより、上記定量
ポンプの流量に等しい除水を行うものである。ここで、
図２では複式ポンプにプランジャーの周動型ポンプ２を
使用し、逆止弁３で液の流れを一方向に整流しており、
また図３では伸縮性膜１３で隔たれた２室を持つチャン
バー１２に加圧ポンプ１１で透析液を送り込み、電磁弁
１０で流路を切り替えることで図２と同様の機能を実現
している。なお、図中６は血液流入路、７は血液流出
路、５は血液ポンプ、９は透析液供給路、８ａは透析排
液路、８ｂは除水路である。In FIGS. 2 and 3, an equal flow circuit of the dialysate is constructed by using a double pump that equalizes the flow rate of the dialysate flowing into the dialyzer 1 and the flow rate of the dialysate flowing out from the dialyzer. By providing the water removing metering pump 4, water is removed by the same amount as the flow rate of the metering pump. here,
In FIG. 2, the plunger type peripheral pump 2 is used for the double pump, and the check valve 3 rectifies the liquid flow in one direction.
In FIG. 3, the dialysate is sent to the chamber 12 having two chambers separated by the stretchable membrane 13 by the pressurizing pump 11 and the flow path is switched by the solenoid valve 10 to realize the same function as in FIG. In the figure, 6 is a blood inflow passage, 7 is a blood outflow passage, 5 is a blood pump, 9 is a dialysate supply passage, 8a is a dialysis drainage passage, and 8b is a drainage passage.

【０００５】[0005]

【発明が解決しようとする課題】これらの方式の利点は
透析液の等流量回路が正確に構成された場合、特に厳し
い流量測定をすることなく必要とする除水精度が得られ
ることである。しかし図２に示す方法では、等流量回路
の精度を得るための圧力調整やプランジャー周動部のシ
ールの耐久性が問題となり、また図３に示す方法では、
電磁弁および伸縮性膜の耐久性が問題となる。また、双
方ともに流れが間欠的となり、これを避けるためには同
じポンプ回路を２つ並列に設け、それぞれ逆相で駆動す
る必要があり構成が複雑となる。The advantage of these methods is that when the dialysate equal flow rate circuit is constructed correctly, the required water removal accuracy can be obtained without particularly strict flow rate measurement. However, in the method shown in FIG. 2, pressure adjustment for obtaining the accuracy of the equal flow circuit and durability of the seal of the plunger peripheral portion become problems, and in the method shown in FIG.
The durability of the solenoid valve and the stretchable membrane becomes a problem. Further, the flow becomes intermittent in both cases, and in order to avoid this, it is necessary to provide two identical pump circuits in parallel and drive them in opposite phases, which complicates the configuration.

【０００６】上記の問題点を解決する血液透析装置とし
て、原理的には図４に示すように非常に簡素な構成が考
えられる。すなわち、透析器１への透析液供給路９側の
定量ポンプ４ａで必要な透析液流量を設定し透析排液路
８側の定量ポンプ４ｂを透析液流量に必要な除水流量を
加算した流量に設定することにより除水を行なうもので
ある。しかしこの場合、透析液供給路側、透析排液路側
各ポンプに非常に厳しい定量性を必要とする。このこと
について、以下に定量的に説明する。As a hemodialysis apparatus which solves the above problems, a very simple structure can be considered in principle as shown in FIG. That is, the required dialysate flow rate is set by the metering pump 4a on the dialysate supply path 9 side to the dialyzer 1, and the metering pump 4b on the dialysate drainage path 8 side is added to the dialysate flow rate by the required dewatering flow rate. Water is removed by setting to. However, in this case, the pumps on the dialysate supply channel side and the dialysate drainage channel side require extremely strict quantitative determination. This will be quantitatively described below.

【０００７】血液透析において通常透析液の流量は透析
効率の関係から５００cc/min前後に設定される。これに
対し除水は５時間透析で約５０００ccの能力を要し、こ
のときの誤差が±３００cc以下になる必要がある。すな
わち除水量は約±１cc/minの誤差以内で制御しなければ
ならない。これは透析液流量制御に対する許容誤差が±
０．２％であることを意味する。この要求に答えるため
に常識的には図５に示すように流量計１４により透析液
流量をフィードバックしたポンプシステムが考えられる
が、要求を満たす流量計を構成することは容易ではな
い。In hemodialysis, the flow rate of dialysate is usually set to about 500 cc / min in consideration of the dialysis efficiency. On the other hand, removal of water requires a capacity of about 5000 cc after dialysis for 5 hours, and the error at this time must be less than ± 300 cc. That is, the amount of water removed must be controlled within an error of about ± 1 cc / min. This has a tolerance of ±
It means 0.2%. In order to meet this demand, a pump system in which the flow rate of the dialysate is fed back by the flow meter 14 as shown in FIG. 5 is conceivable, but it is not easy to construct a flow meter that satisfies the demand.

【０００８】以上の点に鑑み、本発明は図４のように透
析器に対する透析液供給路および透析排液路に独立にポ
ンプを設け、これらの流量差により透析・除水を行なう
場合、各ポンプの流量制御に関し新たな方式を提供し、
より高い除水精度を可能とすることを課題とするもので
ある。In view of the above points, according to the present invention, as shown in FIG. 4, when a pump is provided independently in the dialysate supply passage and the dialysis drainage passage to the dialyzer, and when dialysis and water removal are performed by the flow rate difference between them, Providing a new method for pump flow control,
The object is to enable higher water removal accuracy.

【０００９】[0009]

【課題を解決するための手段】本発明は、透析器の透析
液側に透析液を供給し血液側に血液を供給し、該透析器
内に設けられた浸透性半透膜を介して透析液と血液を接
触させ、血液から老廃物および水分を除去する血液透析
装置において、透析液供給路及び透析排液路にそれぞれ
定量ポンプが設けられ、血液流入路及び血液流出路にそ
れぞれ流量計が設けられ、前記各流量計によって測定さ
れた流量の差によって前記定量ポンプの少なくとも一方
の流量を制御することにより除水を行うことを特徴とす
るものである。The present invention is directed to supplying dialysate to the dialysate side and blood to the blood side of a dialyzer, and dialyzing the same through an permeable semipermeable membrane provided in the dialyzer. In a hemodialysis device that removes waste products and water from blood by bringing liquid into contact with blood, metering pumps are provided in the dialysate supply channel and dialysis drainage channel, and flowmeters are provided in the blood inflow channel and blood outflow channel, respectively. It is characterized in that water is removed by controlling the flow rate of at least one of the metering pumps according to the difference between the flow rates measured by the flow meters.

【００１０】[0010]

【作用】除水量は透析器に対する透析液の流入量と流出
量の差であると同時に血液の流入量と流出量の差でもあ
る。これを式で表わすと単位時間当たりの除水量Ｖは、 Ｖ＝Ｄｏ−Ｄｉ＝Ｂｉ−Ｂｏ となる（ここでＤｉ、Ｄｏ、Ｂｉ、Ｂｏはそれぞれ単位
時間当たりの透析器に対する透析液流入量、透析液流出
量、血液流入量、血液流出量）。すなわち図５のように
透析液流量を測定し透析液流路の各ポンプを制御する代
わりに、血液流量を測定し透析液路のポンプを制御する
ことで除水を制御できる。The amount of water removed is not only the difference between the inflow amount and the outflow amount of the dialysate to the dialyzer but also the difference between the inflow amount and the outflow amount of blood. When this is expressed by an equation, the amount of water removed per unit time V is V = Do-Di = Bi-Bo (where Di, Do, Bi, and Bo are the dialysate inflow amount to the dialyzer per unit time, Dialysate outflow, blood inflow, blood outflow). That is, water removal can be controlled by measuring the blood flow rate and controlling the pumps in the dialysate passage instead of measuring the dialysate flow rate and controlling each pump in the dialysate passage as shown in FIG.

【００１１】また単位時間当たりの除水誤差△Ｖは、 △Ｖ＝△Ｄｏ＋△Ｄｉ＝△Ｂｉ＋△Ｂｏ となる（ここで△Ｄｉ、△Ｄｏ、△Ｂｉ、△Ｂｏはそれ
ぞれ単位時間当たりの透析器に対する透析液流入量、透
析液流出量、血液流入量、血液流出量の誤差）。△Ｖの
許容値は前項で示した通り±１cc/minであるため、△Ｄ
ｉ、△Ｄｏ、△Ｂｉ、△Ｂｏ、それぞれの許容誤差は±
０．５cc/minとなる。ここで通常Ｄｉ、Ｄｏは５００cc
/min程度、またＢｉ、Ｂｏは２００cc/min程度に設定さ
れるので、Ｄｉ、Ｄｏの測定には０．１％以下の精度が
求められるが、Ｂｉ、Ｂｏの測定では０．２５％とな
る。すなわち除水を制御するにあたり除水量を透析液流
量を測定する場合より血液流量を測定する方がより低い
精度の流量計で制御が可能であり、言い替えれば血液流
量測定による除水制御の方がより除水誤差を少なくでき
る。The water removal error ΔV per unit time is ΔV = ΔDo + ΔDi = ΔBi + ΔBo (where ΔDi, ΔDo, ΔBi, and ΔBo are dialysis units per unit time, respectively). Error of dialysate inflow, dialysate outflow, blood inflow, blood outflow to the blood vessel). The allowable value of ΔV is ± 1 cc / min as shown in the previous section, so ΔD
i, ΔDo, ΔBi, ΔBo, the tolerances are ±
It becomes 0.5cc / min. Here, usually Di and Do are 500cc
/ min, and Bi and Bo are set to about 200cc / min. Therefore, an accuracy of 0.1% or less is required for measuring Di and Do, but it is 0.25% for measuring Bi and Bo. .. That is, when controlling the water removal, it is possible to control the water removal amount with a flowmeter having a lower accuracy than when measuring the dialysate flow rate, in other words, the water removal control by measuring the blood flow rate is possible. The water removal error can be reduced.

【００１２】[0012]

【実施例】以下、本発明を図面に基づいて詳細に説明す
る。図１は本発明の実施例を示す図であって、１は透析
器、９は透析液供給路、８は透析排液路、１８及び１９
は定量ポンプ、１６及び１７は流量計、５は血液ポン
プ、６は血液流入路、７は血液流出路、１５は制御部で
ある。DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention will be described below in detail with reference to the drawings. FIG. 1 is a view showing an embodiment of the present invention, in which 1 is a dialyzer, 9 is a dialysate supply passage, 8 is a dialysis drainage passage, and 18 and 19.
Is a metering pump, 16 and 17 are flowmeters, 5 is a blood pump, 6 is a blood inflow path, 7 is a blood outflow path, and 15 is a controller.

【００１３】透析液供給路９と透析排液路８にはそれぞ
れ定量ポンプ１８、１９が設けられている。これらの定
量ポンプ１８、１９は制御部１５よりそれぞれ独立して
制御され、例えば回転数で制御される回転制御式が用い
られる。透析液供給路９に設けられた定量ポンプ１９は
予め設定された流量に対応する一定の回転数で固定運転
される。また、血液は血液ポンプ５により一定流量で透
析器１に供給され、血液流入路６と血液流出路７にそれ
ぞれ設けられた流量計１６、１７は各路の血液流量を検
出し制御部１５に流量の情報を送る。The dialysate supply passage 9 and the dialysate drainage passage 8 are provided with metering pumps 18 and 19, respectively. These metering pumps 18 and 19 are independently controlled by the control unit 15, for example, a rotation control type controlled by the number of rotations is used. The metering pump 19 provided in the dialysate supply passage 9 is fixedly operated at a constant rotation speed corresponding to a preset flow rate. Further, blood is supplied to the dialyzer 1 at a constant flow rate by the blood pump 5, and the flow meters 16 and 17 provided in the blood inflow path 6 and the blood outflow path 7 respectively detect the blood flow rate of each path to the control unit 15. Send flow rate information.

【００１４】制御部１５は流量計１６と流量計１７との
流量の差、すなわち単位時間あたりの除水量を求め、そ
れが予め設定された除水量に相当するように透析排液路
側の定量ポンプ１８の回転数を制御する。流量計１６、
１７には電磁流量計や超音波流量計等を用いることが出
来る。The control unit 15 obtains the difference between the flow rates of the flowmeters 16 and 17, that is, the amount of water removed per unit time, and the metering pump on the dialysis drainage channel side so as to correspond to the preset amount of water removed. The number of rotations of 18 is controlled. Flow meter 16,
An electromagnetic flowmeter, an ultrasonic flowmeter, or the like can be used for 17.

【００１５】[0015]

【発明の効果】本発明によれば血液透析における除水機
能を従来法に比べてより簡単な構成で行うことができ、
結果として血液透析装置の小型化・信頼性の向上・コス
ト軽減が図れる。According to the present invention, the water removal function in hemodialysis can be performed with a simpler structure than the conventional method,
As a result, the size, reliability, and cost of the hemodialysis machine can be reduced.

【図面の簡単な説明】[Brief description of drawings]

【図１】本発明の除水装置の実施例を示す図である。FIG. 1 is a diagram showing an embodiment of a water removing apparatus of the present invention.

【図２】プランジャー周動型複式ポンプを用いた従来の
血液透析装置を示す図である。FIG. 2 is a diagram showing a conventional hemodialysis apparatus using a plunger peripheral type compound pump.

【図３】伸縮性膜で隔たれた２室を持つチャンバーを用
いた従来の血液透析装置を示す図である。FIG. 3 is a diagram showing a conventional hemodialysis apparatus using a chamber having two chambers separated by a stretchable membrane.

【図４】独立した２つのポンプによる除水の原理を示す
図である。FIG. 4 is a diagram showing the principle of water removal by two independent pumps.

【図５】流量計を用いた血液透析装置を示す図である。FIG. 5 is a diagram showing a hemodialysis apparatus using a flow meter.

【符合の説明】[Explanation of sign]

１ 透析器 ５ 血液ポンプ ６ 血液流入路 ７ 血液流出路 ８ 透析排液路 ９ 透析液供給路 １６、１７ 流量計 １５ 制御部 １８、１９ 定量ポンプ 1 dialyzer 5 blood pump 6 blood inflow path 7 blood outflow path 8 dialysis drainage path 9 dialysate supply path 16, 17 flow meter 15 controller 18, 19 metering pump

Claims (1)

【特許請求の範囲】 【請求項１】 透析器の透析液側に透析液を供給し血液
側に血液を供給し、該透析器内に設けられた浸透性半透
膜を介して透析液と血液を接触させ、血液から老廃物お
よび水分を除去する血液透析装置において、透析液供給
路及び透析排液路にそれぞれ定量ポンプが設けられ、血
液流入路及び血液流出路にそれぞれ流量計が設けられ、
前記各流量計によって測定された流量の差によって前記
定量ポンプの少なくとも一方の流量を制御することによ
り除水を行うことを特徴とする血液透析装置。Claim: What is claimed is: 1. A dialysate is supplied to a dialysate side of a dialyzer and blood is supplied to a blood side thereof, and a dialysate is supplied through a permeable semipermeable membrane provided in the dialyzer. In a hemodialysis device for contacting blood to remove waste products and water from blood, a metering pump is provided in each of the dialysate supply passage and the dialysis drainage passage, and a flow meter is provided in each of the blood inflow passage and the blood outflow passage. ,
A hemodialysis apparatus, wherein water removal is performed by controlling the flow rate of at least one of the metering pumps according to the difference in flow rate measured by each flow meter.