WO2018230399A1 - Dispositif de dialyse - Google Patents

Dispositif de dialyse Download PDF

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Publication number
WO2018230399A1
WO2018230399A1 PCT/JP2018/021587 JP2018021587W WO2018230399A1 WO 2018230399 A1 WO2018230399 A1 WO 2018230399A1 JP 2018021587 W JP2018021587 W JP 2018021587W WO 2018230399 A1 WO2018230399 A1 WO 2018230399A1
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WO
WIPO (PCT)
Prior art keywords
tube
unit
blockage
load
lid
Prior art date
Application number
PCT/JP2018/021587
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English (en)
Japanese (ja)
Inventor
浩司 大塚
隼也 広瀬
Original Assignee
株式会社ジェイ・エム・エス
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from JP2017115402A external-priority patent/JP6888433B2/ja
Priority claimed from JP2017115401A external-priority patent/JP2019000167A/ja
Application filed by 株式会社ジェイ・エム・エス filed Critical 株式会社ジェイ・エム・エス
Publication of WO2018230399A1 publication Critical patent/WO2018230399A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/14—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
    • A61M1/16—Dialysis systems; Artificial kidneys; Blood oxygenators ; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis with membranes

Definitions

  • the present invention relates to a dialysis apparatus including a blockage determination unit that determines blockage of a tube.
  • the present invention provides a tube through which a liquid flows, a load detection unit that detects a load due to pressure from the tube, a detection value detected by the load detection unit, and a reference that is a reference for determining the blockage of the tube
  • a blockage determination unit that determines blockage of the tube by comparing with a blockage threshold set based on a value
  • a storage unit that stores in advance the reference value corresponding to the elapsed time that the liquid flows through the tube
  • a correction control unit that updates and corrects the reference value according to an elapsed time based on the reference value stored in the storage unit.
  • the present invention it is possible to provide a dialysis apparatus that can accurately determine the blockage of a tube even when dialysis treatment is performed for a long time.
  • the dialyzer 10 includes a container main body 11 formed in a cylindrical shape and a dialysis membrane (not shown) accommodated in the container main body 11. It is divided into a channel and a dialysate-side flow channel (both not shown). A blood inlet 111 and a blood outlet 112 that communicate with the blood side channel, and a dialysate inlet 113 and a dialysate outlet 114 that communicate with the dialysate side channel are formed in the container body 11.
  • the tubes constituting the artery side line 21, the vein side line 22, the drug line 23, and the overflow line 24 are, for example, flexible tubes such as polyvinyl chloride (PVC) and silicon (Si). It is formed.
  • PVC polyvinyl chloride
  • Si silicon
  • the tube for example, a tube having an outer diameter of 5.5 mm and an inner diameter of 3.3 mm is used.
  • the tube has a hardness of, for example, about 50 to 85 (JIS K7215).
  • the blood pump 212 is arranged on the downstream side of the clamp unit 60 in the artery side line 21.
  • the blood pump 212 sends out liquid such as blood and priming liquid inside the artery side line 21 by squeezing the tube constituting the artery side line 21 with a roller.
  • the one end side of the vein side line 22 is connected to the blood outlet 112 of the dialyzer 10, and the other end side is connected to the vein of the subject (dialysis patient).
  • the venous chamber 222 and the console 100 are arranged in the middle of the venous line 22, the venous chamber 222 and the console 100 are arranged.
  • a clamp unit 60 is disposed at a portion through which the venous line 22 passes.
  • a venous side clamp unit 69 and a venous side bubble sensor 68 are disposed in a portion where the venous side line 22 passes in the clamp unit 60. Details of the clamp unit 60 will be described later.
  • the vein side chamber 222 is disposed between the dialyzer 10 and the console 100 in the vein side line 22.
  • the venous chamber 222 stores a predetermined amount (for example, 20 ml) of blood.
  • the drug line 23 supplies a drug required during hemodialysis to the artery side line 21.
  • One end side (base end side) of the drug line 23 is connected to a chemical pump 231 for sending out the drug, and the other end side (tip end side) is connected between the blood pump 212 and the dialyzer 10 in the artery side line 21.
  • blood taken out from the artery of the subject is circulated through the artery side line 21 by the blood pump 212 and introduced into the blood side channel of the dialyzer 10.
  • the blood introduced into the dialyzer 10 is purified by dialysate flowing through a dialysate circuit 30 described later via a dialysis membrane.
  • the blood purified in the dialyzer 10 is circulated through the venous line 22 and returned to the subject's vein.
  • the dialysate chamber 31 includes a hard container 311 that can store a certain volume (for example, 300 ml to 500 ml) of dialysate, and a soft diaphragm (diaphragm) 312 that partitions the inside of the container 311.
  • the inside of the dialysate chamber 31 is divided into a liquid feeding storage unit 313 and a drainage storage unit 314 by a diaphragm 312.
  • the dialysate introduction line 33 connects the dialysate chamber 31 and the dialysate introduction port 113 of the dialyzer 10, and the dialysate stored in the liquid feed storage portion 313 of the dialysate chamber 31 is supplied to the dialysate side flow path of the dialyzer 10.
  • the bypass line 36 connects the dialysate outlet line 34 and the drainage line 35.
  • a dewatering / back filtration pump 37 is disposed in the bypass line 36.
  • the dewatering / back-filtration pump 37 sends the dialysate inside the bypass line 36 in the direction in which the dialysate is circulated to the drain line 35 (water removal direction) and in the direction in which it is circulated to the dialysate outlet line 34 side (reverse filtration direction). It is composed of a pump that can be driven by liquid.
  • the heater 40 heats the dialysate flowing through the dialysate circuit 30 to a predetermined temperature.
  • the replenisher line 38 is a line for supplying dialysate directly to the blood circuit 20. As shown in FIG. 1, the upstream side of the replenisher line 38 is connected between the dialysate chamber 31 in the dialysate inlet line 33 of the dialysate circuit 30 and the dialysate inlet 113 of the dialyzer 10.
  • the replenisher line 38 is provided with a replenisher clamp 381. As shown by the solid line in FIG. 1, when the downstream side of the replenisher line 38 is connected between the blood pump 212 and the dialyzer 10 in the artery side line 21, predilution-type blood filtration dialysis is performed. Further, as shown by the broken line in FIG. 1, when the downstream side of the replenisher line 38 is connected to the venous chamber 222 in the venous line 22, post-dilution hemofiltration dialysis is performed.
  • the clamp unit 60 includes a unit main body 61, a lid portion 62 that opens and closes the unit main body 61, a hinge portion 63, an open / close lever 641, and an open / close engaging portion 642. .
  • the clamp unit 60 is configured by pressing the inner surface of the lid portion 62 against the inner surface side of the unit main body 61 in a state where the tube configuring the artery side line 21 and the tube configuring the vein side line 22 are arranged on the inner surface of the unit main body 61.
  • the tube constituting the artery side line 21 and the tube constituting the vein side line 22 are fixed.
  • the inner surface of the lid portion 62 constitutes a tube fixing portion that fixes the tube constituting the artery side line 21 and the tube constituting the vein side line 22 with a constant force.
  • a resin material is used, and ABS resin (acrylonitrile-butadiene-styrene copolymer), ASA resin (butadiene of ABS resin) In place of the above, an acrylic rubber polymerized), a synthetic resin such as polypropylene is used.
  • ABS resin acrylonitrile-butadiene-styrene copolymer
  • ASA resin butadiene of ABS resin
  • a synthetic resin such as polypropylene
  • the hinge portion 63 is disposed at the other end portion in the width direction H of the clamp unit 60 when the lid portion 62 is closed, so that the lid portion 62 can be rotated with respect to the unit main body 61. Connecting.
  • the opening / closing lever 641 is provided at one end of the lid 62 in the width direction H when the lid 62 is closed.
  • the opening / closing engagement portion 642 is provided at one end of the inner surface of the unit body 61 in the width direction H so as to be engageable with the opening / closing lever 641 when the lid portion 62 is closed.
  • the main body side artery side tube placement portion 611 is placed on the inner surface of the unit main body 61 as shown in FIG.
  • the main body side arterial tube placement portion 611 includes an arterial side upstream tube pressing portion in order from the upstream side to the downstream side (from the lower side to the upper side in FIG. 3) of the liquid flowing through the tube constituting the arterial line 21.
  • the load is applied to the housing recess 601a of 601, the arterial movable clamp unit 651 of the artery side clamp unit 65, and the shaft 661 for applying a load to the force sensor of the load detection unit 66 (the force sensor itself is not shown, and hereinafter referred to as the force sensor 661).
  • the arterial bubble sensor receiving member 672 in which the ultrasonic oscillation part 671 of the arterial bubble sensor 67 is accommodated, and the accommodating recess 602a of the arterial downstream tube pressing part 602 are arranged side by side. .
  • the lid portion side artery side tube placement portion 621 is placed on the inner surface of the lid portion 62 and is placed opposite to the main body side artery side tube placement portion 611 when the lid portion 62 is closed.
  • the lid side artery side tube placement portion 621 has an artery side upstream tube presser in order from the upstream side to the downstream side of the liquid flowing through the tube constituting the artery side line 21 (from the lower side to the upper side in FIG. 3).
  • Arterial side in which the pressing convex part 601b of the part 601, the arterial clamp receiving part 652 of the arterial side clamp part 65, the load pressing part 663 of the load detecting part 66, and the ultrasonic wave receiving part 673 of the arterial side bubble sensor 67 are housed.
  • the bubble sensor pressing member 674 and the pressing convex portion 602b of the artery side downstream tube pressing portion 602 are arranged side by side.
  • the pressing convex portion 601b of the artery side upstream tube pressing portion 601 is disposed so as to face the accommodating concave portion 601a disposed in the unit main body 61 when the lid portion 62 is closed, and flows through the artery side line 21 in the clamp unit 60. On the upstream side (lower side in FIG. 3), the tube constituting the artery side line 21 is pressed.
  • the arterial clamp 65 configured as described above is disposed between the unit main body 61 and the lid 62 by the arterial movable clamp 651 and the arterial clamp receiver 652 during normal operation of the hemodialysis apparatus 1.
  • the tube constituting the artery side line 21 is clamped.
  • the arterial clamp 65 is opened and closed in a priming and blood return process using physiological saline.
  • the arterial side clamp unit 65 advances and retracts the arterial side movable clamp unit 651 to crush or open the tube constituting the arterial side line 21, and opens and closes the flow path of the arterial side line 21.
  • On the upstream side of 67 the liquid feeding through the inside of the tube is circulated / stopped.
  • the load receiving portion 662 receives pressure from a tube constituting the artery side line 21 pressed by the load pressing portion 663 when the lid portion 62 is closed.
  • the force sensor 661 is disposed on the inner side of the load receiving portion 662 in the unit main body 61.
  • the force sensor 661 detects the load due to the pressure from the tube via the load receiving portion 662 when the load receiving portion 662 moves in the radial direction of the tube by the pressure from the tube acting on the load receiving portion 662. Thereby, the force sensor 661 outputs a load due to the pressure of the tube constituting the artery side line 21 as a voltage.
  • the artery side bubble sensor pressing member 674 presses the tube constituting the artery side line 21 against the artery side bubble sensor receiving member 672 side.
  • the ultrasonic oscillating unit 671 detects the difference between the transmittance of the liquid and the bubble by irradiating the liquid generated in the tube constituting the artery side line 21 with the ultrasonic wave generated from the ultrasonic receiving unit 673. Detect the presence of bubbles.
  • the pressing convex portion 604b of the pressing portion 604 is arranged side by side.
  • the holding convex portion 603b of the vein-side upstream tube pressing portion 603 is arranged to face the accommodating concave portion 603a arranged in the unit main body 61 when the lid portion 62 is closed, and is a liquid flowing through the vein-side line 22 in the clamp unit 60.
  • the tube constituting the vein line 22 is pressed.
  • the vein-side bubble sensor pressing member 684 presses the tube constituting the vein-side line 22 against the vein-side bubble sensor receiving member 682 side.
  • the ultrasonic oscillating unit 681 detects the difference between the transmittance of the liquid and the bubble by irradiating the ultrasonic wave generated from the ultrasonic receiving unit 683 to the liquid flowing in the tube constituting the vein side line 22. Detect the presence of bubbles.
  • the clamp unit 60 configured as described above can be obtained by simply closing the lid 62 in a state where the tube configuring the artery side line 21 and the tube configuring the vein side line 22 are arranged in the unit main body 61. At 60, the tube can be securely clamped.
  • the correction control unit 512 updates and corrects the reference voltage according to the elapsed time based on the reference voltage that is a reference for determining the blockage of the tube stored in the storage unit 52.
  • the correction timing by the correction control unit 512 is performed, for example, at a real-time timing, a predetermined timing interval, a predetermined dialysis treatment timing, or the like.
  • the notification control unit 513 issues a warning in a notification unit such as a display screen, a display lamp, or a speaker.
  • the chamber is disposed in the blood circuit on the artery side, and the pressure in the chamber is measured by a pressure sensor to confirm the blockage of the tube.
  • a pillow is placed in the blood circuit on the artery side, and a medical worker visually confirms the shape change (dent or bulge) of the pillow, thereby confirming the blockage of the tube.
  • dialysis treatment blood is drawn from the human body into the tube, so the inside of the tube has a negative pressure. For example, when the needle tip sticks to the blood vessel wall, the inside of the tube suddenly becomes a negative pressure. Further, when returning blood, the blood in the tube is pushed out to the human body. For example, if a clot is clogged in the needle tip, the inside of the tube suddenly becomes positive pressure.
  • the occlusion is detected using the load detection unit 66 (force sensor 661) without providing the chamber or pillow in the blood circuit on the artery side. Introduced the configuration.
  • the higher the hardness of the tube (Tu1> Tu2> Tu3), the higher the output voltage detected by the load detector 66 and the higher the hardness of the tube (Tu1> Tu2> Tu3).
  • the output voltage detected by the load detection unit 66 has a large fluctuation in the rise and fall of the output voltage only in the initial stage. The fluctuation of the output voltage becomes smaller and approaches stability. That is, as the time passes, the tube becomes familiar with the liquid and temperature changes, and the output voltage detected by the load detection unit 66 also stabilizes with time.
  • the reference voltage Vka is determined before the start of dialysis, and when the pressure falls below, for example, “ ⁇ 400 mmHg”, the blockage is determined to be blocked.
  • a value obtained by subtracting the constant voltage Vc from the reference voltage Vka is defined as a threshold value Vsa.
  • the tube pressure becomes less than the threshold value Vsa when the tube pressure falls below, for example, “ ⁇ 200 mmHg” after 1 hour has elapsed.
  • the blockage determination unit 511 is based on the reference voltage corrected according to the elapsed time. It is possible to accurately determine the blockage. Thereby, even if the output voltage detected by the load detection part 66 changes because the tube becomes familiar with the liquid and the temperature change with the elapsed time, the blockage of the tube can be accurately determined.
  • the output voltage Vs detected by the load detecting unit 66 is corrected by updating the reference voltage Vk according to the elapsed time. Changes following the reference voltage Vk.
  • the output voltage Vs detected by the load detection unit 66 is the threshold value Va when the time Ta has passed. Therefore, it is possible to accurately determine the blockage of the tube.
  • the output voltage Vs detected by the load detection unit 66 exceeds the threshold value Vb when the time Tb is exceeded. It is possible to accurately determine the blockage of the tube.
  • the tube blockage cannot be accurately determined unless correction for updating the reference voltage is performed.
  • the output voltage Vs detected by the load detection unit 66 when the time Tc has passed is It is below the threshold Va when returning blood. Therefore, even if the tube is not blocked, the tube is detected to be blocked, resulting in erroneous detection.
  • the time elapses without performing the correction for updating the reference voltage the time becomes less than the threshold value Va when the time Tc is exceeded. The blockage of the tube is detected at a timing different from the timing when the tube is closed. Therefore, even if the tube is blocked during blood removal or dialysis thereafter, the blockage of the tube cannot be detected at the timing when the tube is actually blocked.
  • the correction control unit 512 updates the reference voltage according to the elapsed time based on the reference voltage used as a reference for determining the blockage of the tube stored in the storage unit 52. It was configured to perform correction control. As a result, in the blood circuit on the artery side, the output voltage detected by the load detection unit 66 changes as the tube becomes familiar with the liquid and temperature changes over time without using a chamber or pillow. In addition, it is possible to accurately determine the blockage of the tube.
  • the storage unit 52 stores a reference voltage serving as a reference for determining the blockage of the tube, and the reference voltage stored in the storage unit 52 is updated by the correction control unit 512 according to the elapsed time.
  • the arterial side clamp portion 65 is provided in a portion through which the arterial line 21 passes.
  • the load detection unit 66 and the artery side bubble sensor 67 are arranged side by side.
  • the medical staff clamps the tube in the clamp unit 60, the tube can be fixed at the artery side clamp portion 65 only by closing the lid portion 62. Therefore, the medical staff can easily perform settings for detecting the presence or absence of air bubbles by the arterial air bubble sensor 67 and detecting the load of the tube by the load detection unit 66.
  • the artery side clamp unit 65, the load detection unit 66, and the artery side bubble sensor 67 are arranged side by side, detection of the tube load by the load detection unit 66 and detection of the presence or absence of bubbles by the artery side bubble sensor 67. Can be performed with high accuracy in the vicinity of the tube fixed at the artery side clamp portion 65.
  • the tube used for detecting the tube load by the load detector 66 is preferably a soft tube in order to increase the time until the output voltage is stabilized.
  • the load detection unit 66 and the artery side bubble sensor 67 are arranged side by side in the clamp unit 60, and the distance between the load detection unit 66 and the artery side bubble sensor 67 tends to be short. It is.
  • the load detection unit 66 and the artery side bubble sensor 67 are arranged side by side, when the tube is too soft, the tube is crushed when the tube is closed, and the load detection unit 66 detects the load of the tube.
  • the arterial bubble sensor 67 may erroneously detect that a bubble is present despite the absence of the bubble in the tube. More specifically, when 36 ° C.
  • the ultrasonic bubble sensor transmits and receives ultrasonic waves through the tube with the portion that transmits the sensor signal in close contact with the tube. A gap is generated in the antenna, making it impossible to receive ultrasonic waves. Since this state is the same as the state in which the reception voltage cannot be obtained when bubbles enter, the artery side bubble sensor 67 is erroneously detected. Therefore, the tube used for detecting the presence or absence of bubbles by the arterial bubble sensor 67 is preferably a hard tube that is not easily crushed to a certain extent so as not to be erroneously detected even during long-term dialysis treatment.
  • the clamp unit 60 when the clamp unit 60 is configured and the load detection unit 66 and the artery side bubble sensor 67 are arranged side by side, detection by the load detection unit 66 and detection by the artery side bubble sensor 67 are performed. It is necessary to select the hardness of the tube so that it can be performed accurately and stably.
  • the tube has a small hardness for load detection by the load detection unit 66, and when the tube hardness is too small, the arterial air bubble sensor 67 detects air bubbles. Considering the possibility of false detection, the tube hardness is increased to some extent. Thereby, even if the artery side bubble sensor 67 and the load detection unit 66 are arranged close to each other, the load detection by the load detection unit 66 can be accurately performed, and the artery side bubble sensor 67 can accurately detect the bubble. Well done.
  • the inner diameter of the tube is 3.3 to 4. 7 mm, a thickness of 0.9 to 1.3 mm, and a JIS hardness of 67 to 73 were preferable.
  • a tube made of polyvinyl chloride (PVC), having an inner diameter of 3.3 mm, a JIS hardness of about 70, and a wall thickness of 1.1 mm is used.
  • the hemodialysis apparatus 1 is used to determine a tube through which a liquid flows, a load detection unit 66 that detects a load due to pressure from the tube, a detection value detected by the load detection unit 66, and a blockage of the tube.
  • a blockage determination unit 511 that determines blockage of the tube by comparing with a blockage threshold set based on a reference voltage that serves as a reference, and a memory that stores in advance a reference voltage corresponding to the elapsed time that the liquid flows through the tube
  • a correction control unit 512 that updates and corrects the reference voltage according to the elapsed time based on the reference voltage stored in the storage unit 52.
  • the notification control unit 513 is configured to notify an alarm when it is determined that the detection value detected by the load detection unit 66 is outside a preset range when the lid 62 is closed. Thereby, when the hardness of the tube is not appropriate, an alarm is notified, so that a tube having an appropriate hardness can be used, and the detection value detected by the load detection unit 66 can be obtained with high accuracy.
  • the hemodialysis apparatus according to the second embodiment is mainly different from the hemodialysis apparatus according to the first embodiment in that the control unit 51 includes a reference value acquisition unit 514.
  • the same components as those of the first embodiment are denoted by the same reference numerals, and the description thereof is omitted or simplified.
  • the reference value acquisition unit 514 stops the blood pump 212 at a predetermined timing when a predetermined time elapses, and acquires a reference voltage based on the load detected by the load detection unit 66 when the liquid is not circulated through the tube.
  • the reference voltage is a reference for determining the blockage of the tube, and is a voltage in a state where no pressure is applied in the tube (the state where the blood pump 212 is stopped), and the tube is blocked. It is the voltage in the state without.
  • a value obtained by subtracting a constant voltage from the reference voltage is set as a threshold value of the output voltage of the load detection unit 66 when the tube has a negative pressure.
  • the threshold value of the output voltage of the load detection unit 66 can be set.
  • a value in a range in which the absolute value of a constant voltage is adjusted may be used as a threshold value in various processes.
  • the operation of stopping the blood pump 212 at a predetermined timing may be automatically performed by the control device 50 or may be performed by a user operation such as a touch on the operation panel 70.
  • the blockage determination unit 511 determines the blockage of the tube by comparing the detection value detected by the load detection unit 66 with a blockage threshold set based on a reference voltage serving as a reference for determining the blockage of the tube. To do.
  • the description of the notification control unit 513 is the same as that of the first embodiment, the description thereof is omitted.
  • the load detection unit 66 force sensor 661
  • the blockage is based on the detection value detected by the load detection unit 66.
  • the reason why the control for determining the blockage of the tube by the determination unit 511 is introduced is the same as in the first embodiment, and thus the description thereof is omitted.
  • the reason for performing the correction for updating the reference voltage is the same as the contents described in FIGS. 8 to 10 regarding the tube in the first embodiment, and thus the description thereof is omitted.
  • the reference voltage by changing the reference voltage, it is possible to determine the blockage of the tube with the desired tube pressure. Therefore, by updating the reference voltage according to the elapsed time, it is possible to determine the blockage of the tube so that there is no erroneous detection over a long period of time.
  • the reference value acquisition unit 514 stops the blood pump 212 at a predetermined timing when a predetermined time elapses, and the reference value is acquired based on the load detected by the load detection unit 66 when the liquid does not flow through the tube. Get the voltage.
  • the blockage determination unit 511 is corrected according to the elapsed time by performing correction to update the reference voltage at a predetermined timing when the predetermined time has elapsed. It is possible to accurately determine the blockage of the tube based on the reference voltage. Thereby, even if the output voltage detected by the load detection part 66 changes because the tube becomes familiar with the liquid and the temperature change with the elapsed time, the blockage of the tube can be accurately determined.
  • Va11 to Va16 are threshold values for blood removal / dialysis obtained by subtracting a predetermined voltage from the reference voltages Vk11 to Vk16
  • Vb11 to Vb16 are threshold values for returning blood by adding a predetermined voltage to the reference voltages Vk11 to Vk16.
  • the output voltage Vs1 detected by the load detection unit 66 is changed to the reference voltages Vk11 to Vk16 by performing correction for updating the reference voltage at a predetermined timing when a predetermined time elapses.
  • the output voltage Vs detected by the load detection unit 66 has the thresholds Va11, Va12, Va13, Va14, Va15, Va16. Therefore, the blockage of the tube can be detected normally.
  • the output voltage Vs detected by the load detector 66 exceeds the threshold values Vb11, Vb12, Vb13, Vb14, Vb15, Vb16, and the tube is blocked normally. Can be detected.
  • the number of updates of the reference voltage can be reduced. Therefore, by reducing the number of times of updating the reference voltage, reducing the number of times of stopping the blood pump 212 and shortening the time for stopping the blood pump 212 can reduce the influence on the longer dialysis time.
  • the update interval is set for each time ta, tb, tc, and td (ta ⁇ tb ⁇ tc ⁇ td), and the number of updates was set to 4 times of T21, T22, T23, and T24.
  • the correction of the reference voltage is performed based on the reference voltage acquired by the load detection unit 66 as in the case of FIG. The blockage can be accurately determined, and the reference voltage update interval can be increased and the number of reference voltage updates can be reduced as compared with the case of FIG.
  • the hemodialysis apparatus 1 includes a tube through which the liquid flows, a blood pump 212 that sends the liquid inside the tube, a load detection unit 66 that detects a load due to pressure from the tube, and a load detection unit 66
  • a blockage determination unit 511 that determines the blockage of the tube by comparing the detected value detected with a blockage threshold value that is set based on a reference voltage that is a reference for determining the blockage of the tube, and when a predetermined time has elapsed.
  • the reference value acquisition unit 514 that acquires the reference voltage based on the load detected by the load detection unit 66 when the blood pump 212 is stopped at a predetermined timing and the liquid is not circulated through the tube, and the reference value acquisition unit 514 And a correction control unit 512 that updates and corrects the reference voltage based on the acquired reference voltage.

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  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Urology & Nephrology (AREA)
  • Anesthesiology (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
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Abstract

La présente invention concerne un dispositif de dialyse apte à déterminer l'occlusion d'un tube avec une bonne précision, même lors de l'exécution d'un traitement de dialyse à long terme. Ce dispositif de dialyse (1) est pourvu : d'un tube à travers lequel s'écoule un liquide ; d'une unité de détection de charge (66) qui détecte une charge due à la pression provenant du tube ; d'une unité de détermination d'occlusion (511) qui détermine l'occlusion du tube en comparant la valeur détectée qui est détectée par l'unité de détection de charge (66) et une valeur seuil d'occlusion définie sur la base d'une valeur de référence servant de référence pour la détermination de l'occlusion du tube ; une unité de stockage (52) qui stocke à l'avance la valeur de référence selon le temps écoulé durant lequel le liquide s'est écoulé à travers le tube ; et une unité de commande de correction (512) qui met à jour et corrige la valeur de référence selon le temps écoulé sur la base de la valeur de référence stockée dans l'unité de stockage (52).
PCT/JP2018/021587 2017-06-12 2018-06-05 Dispositif de dialyse WO2018230399A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
JP2017-115402 2017-06-12
JP2017115402A JP6888433B2 (ja) 2017-06-12 2017-06-12 透析装置
JP2017115401A JP2019000167A (ja) 2017-06-12 2017-06-12 透析装置
JP2017-115401 2017-06-12

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WO2018230399A1 true WO2018230399A1 (fr) 2018-12-20

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2020099584A (ja) * 2018-12-25 2020-07-02 株式会社ジェイ・エム・エス 血液透析装置及び補充液ラインの接続状態検出方法

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