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CN1681541A - 一种用于从血液治疗装置返回血液的方法和实施该方法的装置 - Google Patents

一种用于从血液治疗装置返回血液的方法和实施该方法的装置 Download PDF

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CN1681541A
CN1681541A CNA038216396A CN03821639A CN1681541A CN 1681541 A CN1681541 A CN 1681541A CN A038216396 A CNA038216396 A CN A038216396A CN 03821639 A CN03821639 A CN 03821639A CN 1681541 A CN1681541 A CN 1681541A
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J·贝登
J·曼克
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Fresenius Medical Care Deutschland GmbH
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Abstract

本发明涉及一种用于从一血液治疗装置最好是从一透析装置返回血液的方法。按照本发明，该治疗装置中包括的替代物泵利用适当传递的替代物液体取代血液，直到相应的检测器检测到替代物液体在管线内取代血液而流动。此时，以控制的方式进一步取代血液的体积，直到它到达相应管线的出口。

Description

一种用于从血液治疗装置返回血液的方法 和实施该方法的装置
发明领域
本发明涉及一种用于从一血液治疗装置最好是透析装置返回血液的方法和一种实施该方法的装置。
背景技术
用于不同用途的结构最具变化的透析装置称为血液治疗装置。因此提供一种例如用于血液透析过滤(HDF)的体外血液回路，该回路包括下列部件：一个透析器，至少两个带出口(病人针头)的管线，一个血泵，一个透析液泵，一个设置在该第一管线中的第一阀，一个设置在该第二管线中的第二阀，以及一个用于馈送该替代物流体的稀释前口或稀释后口。
这些单个的部件可以组装成不同的结构。但是，这些相应的部件是一个如例如2002年6月4日的DE 102 24 750.1中描述的整体装置的特别有利的部件。
问题产生于透析时间结束时，此时要求存在于体外回路中的血液尽可能完全地返回病人体内。已经知道为此目的而用于不同血液治疗装置的适当方法。一种用于从一血液治疗装置返回血液的方法描写于例如EP 0 578 175 B1中，同时还引证了其它方法。
从用于由血液治疗装置返回血液的已知方法开始，应用发展一种用于尽可能定量地返回血液的规程，该规程设计成甚至更加简化和尽可能地更加方便。
发明概述
该目的是在一种具有一稀释前口的系统中以一种具有权利要求1的特点的方法来达到的。该目的是用一种有一稀释后口的装置通过一种具有权利要求2中所述的方法步骤的方法来解决的。
因此，按照本发明的第一解决办法的返回血液的方法是在一个包括下列部件的血液治疗装置中实施的：一个血液治疗元件、两个带出口的管线、一个血泵、一个设置在第一管线中的第一阀、一个设置在第二管线中的第二阀和一个用于馈送替代物流体的稀释前口，该稀释前口上连接一个替代物供应管线，该供应管线中插入一替代物泵；该返回血液的方法包括下列步骤：
-第一管线中的第一阀打开而设置在第二管线中的第二阀关闭；
-该血泵调整为馈通，或者它也流动而替代物泵利用输送的替代物流体来取代血液；
-以体积控制的方式进一步取代血液，直到它到达第一管线的出口；
-血泵关闭或停止，第一阀关闭而第二阀打开；
-取代物泵通过释放的第二管线和血液治疗元件用输送的替代物流体取代血液；以及
-以体积控制的方式进一步取代血液，直到它到达第二管线的出口。
按照本发明的第二解决办法，该返回血液的方法是在一个包括下列部件的血液治疗装置中实施的：一个血液治疗元件、两个带出口的管线、一个血泵、一个设置在第一管线中的第一阀、一个设置在第二管线中的第二阀和一个用于输送替代物流体的稀释后口，该稀释后口上连接一个替代物供应管线，该供应管线中插入一替代物泵；该返回血液的方法包括下列步骤：
-第一管线中的第一阀打开而设置在第二管线中的第二阀关闭；
-该血泵调整为馈通，或者它也流动而替代物泵利用输送的替代物流体通过血液治疗元件和第一管线来取代血液；
-以体积控制的方式进一步取代血液，直到它到达第一管线的出口：
-血泵关闭或停止，第一阀关闭而第二阀打开；
-取代物泵通过稀释的第二管线用输送的替代物溶液取代血液；以及
-以体积控制的方式进一步取代血液，直到它到达第二管线的出口。
本发明的解决办法允许动脉和静脉同等地返回血液。与带有动脉中断和随后的静脉中断的标准方法相反，病人的中断只是在返回手续结束时才需要。然后，首先中断动脉入口并将其连接到含生理盐水的冲洗溶液袋。然后软管系统中的血液借助于血泵而经过静脉连接返回病人体内。该返回在该过程中是手动监控的。
按照本发明，对于返回的开始不需要围绕病人变换连接。
该替代物泵特别有利于地用于供应流体，由此在加入的溶液和血液之间产生良好的分离边界。
按照本发明的一个优选方面，按照附属的权利要求3，一个具有高度精确的配料性能的隔膜泵用作替代物泵。与两个光学传感器相配合，这允许血液在一精确点上十分有效地返回，因为这些管线中从传感器到管线出口的残余体积是已知的，而该已知的体积可以在从该管线的一个精确点处通过该具有高度精确的配料性能的隔膜泵的相应控制而取代。
该方法的进一步的有利发展产生于其它附属的权利要求。
该发明最后涉及一种按照权利要求9的装置。该装置的有利方面产生于附属其下的子权利要求。
附图简述
下面参照附图中示出的实施例来说明本发明的进一步的细节、特点和优点。唯一的附图表示可以实施本发明的方法的一种在线的血液透析过滤装置的基本回路图。
优选实施例说明
图中所示的透析装置10包括一个透析器12、一个作成隔膜泵的血泵14、一个同样作成隔膜泵的替代物、一个作为动脉血管线的第一管线18和一个作为静脉血管线的第二管线20。在血液治疗期间，一个第一阀22沿第一管线18中的输送方向设置在血泵14的上游。血泵14和替代物泵16两者均做成并联的双泵，这使得输血几乎均匀。一个第二阀24设置在第二管线20中。一个第一光学检测器26设置在第一管线中，而一个第二光学检测器28设置在第二管线中。
替代物泵16从替代物源30通过替代物供应管线31将替代物溶液或者输送到稀释前口32或者输送到稀释后口34。替代物源30可以是一个含有合适的流体或在透析装置10内的制剂单元，后者在原位制备一种合适的流体。
在替代物泵16将替代物送到稀释前口32的情况下，在用于使血液从透析装置10返回病人(此处未详细示出)的透析结束后，第一管线18中的第一阀22打开而第二管线20中的第二阀24关闭。血液在血泵14外面极大地受压。血泵14调整到馈通或者它最好也在压力控制下运转，同时替代物泵16利用输送的替代物流体而与正常流动方向相反地移动管线18中的血液，直到在第一光学检测器26中检测到替代物流体正取代血液而回流。光学检测器检测到这一点是由于替代物相对于血液要轻得多。
此时，血液以体积控制的方式进一步移动，直到它到达第一管线的出口。在第一检测器26之后直到该管线出口的剩余管线中的体积是精确已知的，而所要体积可以利用高度精确的替代物分配泵16来精确地取代。在取代血液的体积部分后，动脉血以定量方向极大地引回病人体内。
为了返回静脉血，血泵现在关闭或停止，而第一阀22关闭，同时第二阀24打开。替代物泵现在通过释放的第二管线20并通过透析器12用输送的替代物流体取代血液，直到在第二检测器28中被检测到该替代物流体取代血液而回流。血液现在重新以体积控制的方式进一步移动，直到它到达第二管线的出口，使得静脉血现在也已返回病人体内。
如果替代物流体现在并不通过稀释前口32增加，而是通过稀释后口34增加，那么上述方法修改为替代物溶液在取代动脉血时已经通过透析器12而流动并以上述方法取代相应的血液以及其后在管线18中的血液。
上述倒空第一管线18和随后倒空第二管线20的顺序当然也能够在本发明的架构内交换。

Claims (11)

1.一种用于从一个包括一血液治疗元件的血液治疗装置最好是一个透析装置返回血液的方法，该装置有一透析器、两个带出口的管线、一个血泵、一个被设置在该第一管线中的第一阀、一个被设置在该第二管线中的第二阀和一个用于输送替代物流体的稀释前口，一个替代物供应管线连接在该稀释前口上，并且将一替代物泵插入该供应管线内；该方法的特征在于下列步骤：
-将该第一管线中的第一阀打开，而将被设置在该第二管线中的第二阀关闭；
-将该血泵调整为馈通，或者它也运行而该替代物泵用被输送的替代物流体来取代血液；
-以体积控制的方式进一步取代血液，直到它到达该第一管线的出口；
-将血泵关闭或停止，使该第一阀关闭而第二阀打开；
-该取代物泵通过该释放的第二管线和血液治疗元件用被输送的替代物流体取代血液；以及
-以体积控制的方式进一步取代血液，直到它到达该第二管线的出口。
2.一种用于从一个包括一血液治疗元件的血液治疗装置最好是一个透析装置返回血液的方法，该装置有一透析器、两个带出口的管线、一个血泵、一个被设置在第一管线中的第一阀、一个被设置在第二管线中的第二阀和一个用于输送替代物流体的稀释后口，一个替代物供应管线被连接在该稀释后口上，并且将一替代物泵插入该供应管线内；该方法的特征在于下列步骤：
-将该第一管线中的第一阀打开，而将被设置在该第二管线中的第二阀关闭；
-将该血泵调整为馈通，或者它也运行而该替代物泵用被输送的替代物流体通过该血液治疗元件和该第一管线来取代血液；
-以体积控制的方式进一步取代血液，直到它到达该第一管线的出口；
-将血泵关闭或停止，使该第一阀关闭而该第二阀打开；
-该取代物泵通过该释放的第二管线用被输送的替代物溶液取代血液；以及
-以体积控制的方式进一步取代血液，直到它到达该第二管线的出口。
3.一种按照权利要求1或2的方法，其特征在于，将一个高度精确的分配隔膜泵用作该替代物泵。
4.一种按照上述权利要求中任何一项的方法，其特征在于，该血液治疗元件是一个血液透析过滤中的透析器。
5.一种按照上述权利要求中任何一项的方法，其特征在于，该血液治疗元件是一个血液透析过滤中的血液过滤器。
6.一种按照上述权利权利要求中任何一项的方法，其特征在于，通过检测器检测替代物流体取代血液而流回。
7.一种按照权利要求6的方法，其特征在于，使用了光学检测器。
8.一种按照上述权利要求中任何一项的方法，其特征在于，该血液被大量地压出该血泵。
9.一种用于实施按照上述权利要求中任何一项的方法的装置，其特征在于有一血液治疗元件(12)、一血泵(14)、一替代物泵(16)、一作为动脉血管线的第一管线(18)、一作为静脉血管线的第二管线(20)、阀(22，24)和一控制装置。
10.一种按照权利要求9的装置，其特征在于，在管线(18，20)中设置了检测器(26，28)，最好是光学检测器。
11.按照权利要求10和11的装置，其特征在于，将泵(14，16)制造成并联的双泵。
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