JP2013048803A - Blood purification system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a blood purification system that when an air bubble is detected during an arterial transfusion step, automatically alters the direction of motion of the bubble and can ease the burden on a medical professional.SOLUTION: The blood purification system includes a control means 19 causing the following steps to be performed: a vein-side retransfusion step S1 for performing retransfusion having replaced the blood from the section of a blood circuit connecting to a physiological saline solution supply line 8 to the tip of a vein-side blood circuit 2 with a physiological saline solution, upon retransfusion; an artery-side retransfusion step S4 for performing retransfusion having replaced the blood from the section of the blood circuit connecting to the physiological saline solution supply line 8 to the tip of an artery-side blood circuit 1 with a physiological saline solution; and a recovery step S8 for causing the detected bubble to flow to a blood pump 4 side by means of a connection section, and then shifted to the vein-side retransfusion step S1, on condition that an artery-side bubble detection means 10 has detected a bubble during the artery-side retransfusion step S4.

Description

  The present invention relates to a blood purification apparatus for purifying a patient's blood while circulating it extracorporeally, such as dialysis treatment using a dialyzer.

  A dialysis device as a blood purification device includes an arterial blood circuit with an arterial puncture needle attached to the tip, a blood circuit comprising a venous blood circuit with a venous puncture needle attached to the tip, an arterial blood circuit, and a vein A dialyzer disposed between the side blood circuits to purify blood flowing through the blood circuit, a blood pump disposed in the arterial blood circuit, and a blood pump disposed in the arterial blood circuit and the venous blood circuit, respectively. It mainly comprises an arterial air trap chamber and a venous air trap chamber for foaming, and a dialyzer body capable of supplying dialysate to the dialyzer.

  In addition, a storage bag containing physiological saline is connected between the arterial puncture needle and the blood pump in the arterial blood circuit via a physiological saline supply line, and during priming before dialysis treatment, dialysis is performed. The physiological saline solution in the accommodation bag can be supplied into the blood circuit via the physiological saline supply line at the time of fluid replacement during treatment or when returning blood after dialysis treatment. For example, at the time of returning blood, physiological saline solution is supplied into the blood circuit as a replacement liquid, and blood can be returned by replacing the blood in the blood circuit with the replacement liquid (for example, Patent Document 1). reference).

  Recently, there is an increasing need to automate various processes in blood purification treatment in order to reduce the burden on medical staff. For example, when returning blood, the blood pump is driven forward so that the blood from the connection portion with the replacement fluid supply line in the blood circuit to the tip of the venous blood circuit is replaced with the replacement fluid and returned. (This is called the venous side blood return step) and by rotating the blood pump in reverse, the blood from the connection portion with the replacement fluid supply line in the blood circuit to the tip of the arterial blood circuit is replaced with the replacement fluid. There has been proposed a blood purification apparatus provided with a control means for alternately performing a blood return process for returning blood (this is referred to as an arterial blood return process) (see, for example, Patent Document 2).

JP 2006-280775 A Japanese Patent Laid-Open No. 6-261938

However, the conventional blood purification apparatus has the following problems.
While blood is circulating extracorporeally at the time of blood purification treatment, the upstream side of the blood pump arrangement position in the arterial blood circuit (specifically, the iron that is connected to the arterial blood circuit and is squeezed by the blood pump) Air bubbles tend to accumulate in the upstream portion of the tube) and the connecting portion (T-tube, etc.) with the physiological saline supply line. In particular, the upstream side of the position where the blood pump is disposed in the arterial blood circuit tends to be relatively negative pressure, and dissolved oxygen in the blood is easily bubbled.

  However, since a venous air trap chamber for defoaming is usually connected to the venous blood circuit, it is possible to drive the blood pump in the normal direction to connect the replacement circuit supply line in the blood circuit. In the venous return process in which blood from the venous side to the distal end of the venous side blood circuit is replaced with a replacement liquid to return blood, the air bubbles retained during the treatment can be captured in a venous side air trap chamber or the like.

  On the other hand, since the air trap chamber or the like for defoaming is not normally connected between the position of the blood pump in the artery side blood circuit and the tip of the artery side blood circuit, the blood pump is reversed. In the arterial blood return process in which the blood from the connection with the replacement fluid supply line in the blood circuit to the tip of the arterial blood circuit is replaced by the replacement fluid to return blood, Moves to the distal end side of the arterial blood circuit, and the bubble detecting means disposed at the distal end of the arterial blood circuit detects the bubbles and issues an alarm.

  When such an alarm is issued, it is necessary for a medical worker to immediately go to the blood purification device to perform an operation for canceling the alarm, which is troublesome and reduces the effect of automation. . In addition, while the alarm is being issued, the blood return operation is usually stopped, so that the blood flow in the blood circuit is stopped, which increases the risk of blood clots. . Such problems are not limited to those having a venous return step and an arterial return step when returning blood. For example, the dialysate is reverse-filtered from the dialyzer to the blood circuit side and dialyzed as a replacement solution. This also occurs in the case where a liquid is used.

  The present invention has been made in view of such circumstances, and when bubbles are detected during blood return, the movement direction of the bubbles can be automatically changed to reduce the burden on the medical staff. An object of the present invention is to provide a blood purification device that can perform the above.

  The invention according to claim 1 is composed of an arterial blood circuit and a venous blood circuit, a blood circuit capable of extracorporeally circulating a patient's blood from the tip of the arterial blood circuit to the tip of the venous blood circuit, and the blood A blood purification means for purifying blood flowing between the arterial blood circuit and the venous blood circuit of the circuit, and disposed in the arterial blood circuit to drive the liquid in the blood circuit A blood pump that can flow in a direction, an artery-side bubble detecting means that is disposed in the vicinity of the tip of the artery-side blood circuit, and that can detect bubbles in the liquid flowing in the flow path, and after treatment, the replacement fluid is the blood A blood purification apparatus comprising: a control means capable of supplying blood to the circuit and replacing the blood in the blood circuit with the replacement liquid to return the blood. Detecting bubbles Condition, characterized in that could carry out the recovery step of normal rotation of the blood pump.

  According to a second aspect of the present invention, in the blood purification apparatus according to the first aspect, the blood purification device is connected between the position of the blood pump in the arterial blood circuit and the tip of the arterial blood circuit. A replacement fluid supply line capable of supplying a replacement fluid for replacing blood to the arterial blood circuit, a closed state that blocks the flow path of the replacement fluid supply line, and a flow state that allows the replacement fluid to flow freely Switching means capable of switching, and at the time of returning blood, the control means replaces blood from a connection portion with the replacement fluid supply line in the blood circuit to a tip of the venous blood circuit with the replacement fluid. Blood return from the venous side blood return step and blood from the connecting part of the blood circuit to the tip of the arterial blood circuit is replaced with the replacement liquid to return the blood. Process And the recovery step drives the blood pump forward on the condition that the arterial-side bubble detection means has detected a bubble during the arterial-side blood return step, and at least the detected bubble is It is a process of making it transfer to the said venous side blood return process after making it flow to the said blood pump side from a connection part, It is characterized by the above-mentioned.

  According to a third aspect of the present invention, in the blood purification apparatus according to the second aspect, the blood pump can be driven to rotate forward and reversely, and the control means can perform the blood pump in the venous blood return step. , And the blood pump is reversely driven in the arterial blood return step.

  According to a fourth aspect of the present invention, in the blood purification apparatus according to the second or third aspect, the arterial valve is provided so that the vicinity of the tip of the arterial blood circuit can be opened and closed, and the flow path can be closed and opened. And a venous valve means that is provided so as to be capable of opening and closing the vicinity of the distal end of the venous blood circuit and capable of closing and opening the flow path, and the control means includes the artery in the recovery step. The side valve means and the vein side valve means are opened, and the switching means is closed.

  According to a fifth aspect of the present invention, in the blood purification apparatus according to any one of the second to fourth aspects, the control means alternately performs the venous return step and the arterial return step multiple times. And the recovery step is performed on the condition that the arterial bubble detection means detects a bubble during the arterial blood return step.

  A sixth aspect of the present invention is the blood purification apparatus according to any one of the first to fifth aspects, wherein the venous blood circuit or the arterial blood circuit downstream from the blood pump is defoamed. An air trap chamber is connected.

  According to a seventh aspect of the present invention, in the blood purification apparatus according to any one of the second to sixth aspects, the switching means includes an electromagnetic valve disposed in the replacement liquid supply line, and the electromagnetic valve It is possible to switch between the closed state and the distribution state by opening and closing.

  According to an eighth aspect of the present invention, in the blood purification apparatus according to any one of the second to sixth aspects, the switching means includes a squeezing pump disposed in the replacement liquid supply line, and The closed state and the flow state can be switched by stopping or driving the mold pump.

  According to the first aspect of the present invention, the control means can perform a recovery step of driving the blood pump in a forward direction on the condition that the arterial bubble detection means has detected a bubble when returning blood. When bubbles are detected in, the movement direction of the bubbles can be automatically changed, and the burden on the medical staff can be reduced.

  According to the invention of claim 2, the blood pump is driven to rotate forward on the condition that the arterial bubble detection means has detected the bubble during the arterial blood return step, and the detected bubble is at least connected to the blood pump side from the connection portion. After the fluid is flowed to the venous side, a recovery step is performed to shift to the venous side blood return step, so that when the air bubbles are detected during the arterial side blood return step, the movement direction of the bubbles can be automatically changed, The burden on workers can be reduced.

  According to the invention of claim 3, the blood pump can be driven forward and backward, and the control means drives the blood pump forward in the venous side blood return step, and blood in the arterial side blood return step. Since the pump is driven in reverse, the blood return by the venous side blood return step and the arterial side blood return step can be performed well and reliably.

  According to the invention of claim 4, the control means opens the arterial side valve means and the venous side valve means and closes the switching means in the recovery step, so that bubbles are not generated in the arterial side blood return step. When detected, the moving direction of the bubbles can be changed automatically and smoothly.

  According to the invention of claim 5, the control means causes the venous side blood return step and the arterial side blood return step to be alternately performed a plurality of times, and the arterial side bubble detection means during the arterial side blood return step. Since the recovery process is performed on the condition that air bubbles have been detected, the blood from the connection with the replacement liquid supply line in the blood circuit to the tip of the venous blood circuit in the blood return process, and the replacement liquid in the blood circuit It is possible to prevent blood from coagulating from the connection with the supply line to the tip of the arterial blood circuit, and automatically move the air bubbles when air bubbles are detected during the arterial blood return process The direction can be changed, and the burden on the medical staff can be reduced.

  According to the invention of claim 6, since the air trap chamber for defoaming is connected to the venous blood circuit or the arterial blood circuit downstream from the blood pump, in the venous blood return step, the air Air bubbles can be reliably captured by the trap chamber.

  According to the invention of claim 7, the switching means is composed of an electromagnetic valve arranged in the replacement liquid supply line, and can be switched between a closed state and a flow state by opening and closing the electromagnetic valve. It can be easily applied to a configuration in which a storage means storing physiological saline is connected to the proximal end of the replacement liquid supply line, and physiological saline as a replacement liquid is supplied to the blood circuit by its own weight.

  According to the invention of claim 8, the switching means is composed of the ironing type pump disposed in the replacement liquid supply line, and can be switched between the closed state and the flow state by stopping or driving the ironing type pump. Therefore, the base of the replacement fluid supply line is connected to the dialysate introduction line for supplying dialysate to the blood purification means, and the peristaltic pump is driven so that the dialysate as the replacement fluid is supplied to the blood circuit. It can be easily applied to the form of supply.

The schematic diagram which shows the blood purification apparatus (at the time of a venous side blood return process) which concerns on embodiment of this invention. Schematic showing the blood purification device (at the time of pressure accumulation in the arterial blood return process) Schematic showing the blood purification device (at the time of blood return in the arterial blood return process) Schematic showing the blood purification device (during the recovery process) Flow chart showing control contents at the time of blood return in the blood purification apparatus The flowchart which shows the other control content at the time of blood return in the blood purification apparatus Schematic showing the blood purification device (during other recovery process and venous return process) The schematic diagram which shows the blood purification apparatus which concerns on other embodiment of this invention. Schematic diagram showing a blood purification apparatus according to still another embodiment of the present invention. The schematic diagram which shows the blood purification apparatus (at the time of a recovery process) which concerns on the same embodiment

Hereinafter, embodiments of the present invention will be specifically described with reference to the drawings.
The blood purification apparatus according to this embodiment includes a dialysis apparatus for performing dialysis treatment. As shown in FIG. 1, a blood circuit including an arterial blood circuit 1 and a venous blood circuit 2, and an arterial blood circuit 1. And a dialyzer 3 (blood purification means) interposed between the venous blood circuit 2 and purifying blood flowing through the blood circuit, a blood pump 4, and the arterial blood circuit 1 and venous blood circuit 2, respectively. Arterial side air trap chamber 5 and venous side air trap chamber 6, dialyzer main body B capable of supplying dialysate 3 to dialyzer 3, physiological saline supply line 8 as a replacement fluid supply line, and replacement fluid as a replacement fluid It is mainly composed of an accommodating means 9 for accommodating a physiological saline, an arterial side bubble detecting means 10 and a venous side bubble detecting means 11.

  The arterial blood circuit 1 is connected with an arterial puncture needle at the tip thereof, and an iron-type blood pump 4 and an arterial air trap chamber 5 for defoaming are disposed in the middle of the arterial blood circuit 1. A venous puncture needle is connected to the distal end of the side blood circuit 2, and a venous air trap chamber 6 is connected to the side blood circuit 2. The arterial air trap chamber 5 and the venous air trap chamber 6 are formed with an air layer, capable of capturing bubbles in the liquid, and provided with a filtration network (not shown). It is now possible to capture blood clots and the like. Among these, the arterial air trap chamber 5 is disposed downstream of the blood pump 4 in the arterial blood circuit 1 (between the blood pump 4 and the dialyzer 3 in the arterial blood circuit 1).

  The blood pump 4 is composed of a squeezing type pump disposed in the arterial blood circuit 1 and is capable of normal rotation and reverse rotation, and can flow the liquid in the blood circuit in the driving direction. That is, the arterial blood circuit 1 is connected to a corrugated tube 1a that is softer and larger in diameter than the other flexible tubes that constitute the arterial blood circuit 1, and the blood pump 4 includes the corrugated tube 1a. A roller for squeezing the tube 1a in the longitudinal direction is provided. When the blood pump 4 is driven in this manner, the roller rotates to squeeze the ironing tube 1a, and the liquid inside can flow in the driving direction (rotating direction of the roller).

  When the blood pump 4 is driven to rotate forward (left rotation in the figure) while the patient is punctured with the arterial puncture needle and the venous puncture needle, the blood of the patient passes through the arterial blood circuit 1 and the dialyzer. After reaching 3, blood purification is performed by the dialyzer 3, and defoaming is performed in the venous air trap chamber 6, and then returns to the patient's body through the venous blood circuit 2. That is, the blood of the patient is purified by the dialyzer 3 while circulating externally from the tip of the arterial blood circuit 1 to the tip of the venous blood circuit 2 of the blood circuit.

  The dialyzer 3 is formed with a blood introduction port 3a, a blood outlet port 3b, a dialysate inlet port 3c, and a dialysate outlet port 3d in the casing. Among these, the blood inlet port 3a includes the arterial blood circuit 1. However, the venous blood circuit 2 is connected to the blood outlet port 3b. The dialysate introduction port 3c and the dialysate lead-out port 3d are connected to a dialysate introduction line La and a dialysate discharge line Lb extending from the dialyzer body B, respectively.

  A plurality of hollow fibers are accommodated in the dialyzer 3, the inside of the hollow fibers is used as a blood flow path, and the flow of dialysate is between the hollow fiber outer peripheral surface and the inner peripheral surface of the housing. It is considered a road. A hollow fiber membrane is formed in the hollow fiber by forming a large number of minute holes (pores) penetrating the outer circumferential surface and the inner circumferential surface, and impurities in the blood are passed through the membrane in the dialysate. It is comprised so that it can permeate | transmit.

  On the other hand, the dialyzer main body B is provided with a dual pump 17 across the dialysate introduction line La and the dialysate discharge line Lb, and the bypass line Lc that bypasses the dual pump 17 is provided in the dialyzer 3. A dewatering pump 18 is provided for removing water from the flowing patient's blood. Furthermore, one end of the dialysate introduction line La is connected to the dialyzer 3 (dialyte introduction port 3c), and the other end is connected to a dialysate supply device (not shown) for preparing a predetermined concentration of dialysate. In addition, one end of the dialysate discharge line Lb is connected to the dialyzer 3 (dialysate outlet port 3d), and the other end is connected to a drain means (not shown), and the dialysate supplied from the dialysate supply device After passing through the dialysate introduction line La to the dialyzer 3, it is sent to the drainage means through the dialysate discharge line Lb.

  Note that a pressure sensor 21 is connected to the venous air trap chamber 6 via a monitor tube so that the fluid pressure (venous pressure) in the venous air trap chamber 6 can be measured. An overflow line 20 is extended from the upper part (air layer side) of the vein-side air trap chamber 6, and an electromagnetic valve V4 is disposed in the middle thereof. Then, by opening the electromagnetic valve V4, the liquid (priming liquid or the like) flowing in the blood circuit can be overflowed via the overflow line 20.

  A physiological saline supply line 8 (substitution liquid supply line) is connected at one end to a T-shaped tube T between the position of the blood pump 4 in the artery-side blood circuit 1 and the tip of the artery-side blood circuit 1. The flow path (for example, a flexible tube etc.) which can supply the physiological saline solution (substitution liquid) for replacing with the blood in the blood circuit to the artery side blood circuit 1 is provided. The other end of the physiological saline supply line 8 is connected to a storage means 9 that stores a predetermined amount of physiological saline, and an air trap chamber 7 is connected in the middle. Reference numeral 16 in the figure denotes a tube detector comprising a sensor or the like for detecting the presence or absence of the physiological saline supply line 8.

  Further, the physiological saline supply line 8 according to the present embodiment is provided with an electromagnetic valve V3 as a switching means. The electromagnetic valve V3 is provided so that the physiological saline supply line 8 can be opened and closed, and the flow path can be closed and opened. By opening and closing the electromagnetic valve V3, the physiological saline supply line 8 flows. It is possible to arbitrarily switch between a closed state in which the path is closed and a flowing state in which a physiological saline solution (substitution solution) can flow. The electromagnetic valve V3 is configured such that the opening / closing operation at the time of returning blood is controlled by the control means 19 described in detail later.

  Further, in the vicinity of the arterial puncture needle in the arterial blood circuit 1 (near the tip of the arterial blood circuit 1 and the connection portion of the physiological saline supply line 8 (position of the T-shaped tube T) and the arterial puncture needle. Between the vein side blood circuit 2 and the vicinity of the vein side puncture needle (near the tip of the vein side blood circuit 2 and between the vein side air trap chamber 6 and the vein side puncture needle). And a solenoid valve V2 as a venous valve means. These solenoid valves V1 and V2 are capable of closing and opening the flow paths in the respective portions provided by opening and closing operations, and the opening and closing operations at the time of returning blood are performed by the control means 19 described in detail later. It is configured to be controlled.

  In addition, an arterial-side bubble detecting means 10 is disposed in the vicinity of the tip of the arterial blood circuit 1 (near the electromagnetic valve V1 as the arterial-side valve means), and in the vicinity of the tip of the venous-side blood circuit 2 (the venous valve). In the vicinity of the electromagnetic valve V2 as a means), the venous side bubble detecting means 11 is disposed. The arterial-side bubble detection means 10 and the venous-side bubble detection means 11 are composed of sensors that can detect bubbles in the liquid flowing in the flow path, and are electrically connected to the control means 19. In the figure, reference numerals 12 and 13 and reference numerals 14 and 15 denote blood discriminators disposed near the tip of the arterial blood circuit 1 and near the tip of the venous blood circuit 2 (where blood flows in the flow path). And a tube detector (a sensor or the like for detecting the presence or absence of the arterial blood circuit 1 and the venous blood circuit 2).

  In the dialysis apparatus main body B according to the present embodiment, a control means 19 composed of, for example, a microcomputer is disposed. The control means 19 is electrically connected to sensors such as actuators such as blood pump 4 and electromagnetic valve V3 (switching means), arterial side bubble detection means 10 and venous side bubble detection means 11 and blood discriminators 12 and 13, for example. Connected, and after blood purification treatment, the physiological valve (substitution) is made to flow and the physiological saline (substitution fluid) is supplied to the blood circuit, and the blood in the blood circuit is physiological saline (substitution fluid). ) To return blood.

  More specifically, the control means 19 drives the blood pump 4 to rotate forward at the time of returning blood, and from the connection portion (position of the T-shaped tube T) to the physiological saline supply line 8 in the blood circuit, the venous blood circuit 2 is connected to the physiological saline supply line 8 in the blood circuit by reversely driving the blood pump 4 to return the blood up to the tip of the blood 2 by replacing the blood with physiological saline to return the blood. It is supposed that an arterial blood return step (see FIG. 3) for returning blood by replacing the blood from (position of the T-shaped tube T) to the tip of the arterial blood circuit 1 with physiological saline. .

  Here, on the condition that the arterial bubble detection means 10 has detected a bubble during the arterial blood return step, the control means 19 according to the present embodiment transfers the detected bubble to the connecting portion (position of the T-shaped tube T). ), A recovery process (see FIG. 4) for transferring to the blood pump 4 side and then a venous blood return process is performed. That is, when the arterial bubble detection means 10 detects a bubble in the arterial blood return step, an alarm is issued directly in the prior art, whereas in the present embodiment, a recovery step is performed instead of generating an alarm. The control means 19 is supposed to perform this.

  Even when air bubbles (such as air bubbles generated in the ironing tube 1a) are generated upstream of the blood pump 4 during the blood purification treatment, the generated air bubbles are venous during the venous blood return process. In the process of flowing toward the side blood circuit 2 side, the air bubbles are trapped in the artery side air trap chamber 5 or the vein side air trap chamber 6. Is detected by the arterial bubble detection means 10 in the process of flowing toward the distal end side, and in the recovery process, the detected bubble is caused to flow from the connecting portion (position of the T-shaped tube T) to the blood pump 4 side. Thereafter, the process can be shifted to a venous return process. Then, at the time of the venous blood return process, the air bubbles detected by the arterial air bubble detecting means 10 are captured in the arterial air trap chamber 5 or the venous air trap chamber 6.

Next, the control content at the time of blood return by the control means 19 which concerns on this embodiment is demonstrated based on the flowchart of FIG.
When blood return is started after the blood purification treatment, the control means 19 controls the connection from the physiological saline supply line 8 in the blood circuit (position of the T-shaped tube T) to the tip of the venous blood circuit 2. A venous-side blood return step S1 is performed in which the blood is returned to a physiological saline solution (replacement solution) and returned. As shown in FIG. 1, the venous side blood return step S1 includes the electromagnetic valve V1 (arterial side valve means) being closed and the electromagnetic valve V2 (venous side valve means) being opened, as well as the electromagnetic valve V3 ( The switching means) is opened and the blood pump 4 is driven to rotate forward.

  By this first venous side blood return step S1, a predetermined amount of the blood from the connection portion (position of the T-shaped tube T) with the physiological saline supply line 8 in the blood circuit to the tip of the venous side blood circuit 2 is physiologic. The blood will be returned to blood after being replaced with a saline solution (substitution solution). Then, it is determined whether or not the physiological saline supplied in the first venous blood return step S1 has reached a predetermined volume (S2), and if it is determined that the predetermined volume has been reached, the first venous side After the blood return step S1 is completed, the process proceeds to the pressure accumulation step S3. The predetermined amount in S2 can be grasped by detecting the driving time or the flow rate of the blood pump 4, for example.

  The pressure accumulation step S3 is a step performed before the arterial blood return step S4. As shown in FIG. 2, the electromagnetic valve V1 (arterial side valve means) and the electromagnetic valve V2 (venous side valve means) are in a closed state. At the same time, the electromagnetic valve V3 (switching means) is opened and the blood pump 4 is driven to rotate forward. With this pressure accumulation step S3, a physiological saline solution (substitution fluid) for use in the subsequent arterial blood return step S4 can be stored in the blood circuit downstream of the site where the blood pump 4 is disposed.

  When the pressure accumulation step S3 is completed, an arterial blood return step S4 is performed. In this arterial blood return step S4, the blood from the connecting portion (position of the T-shaped tube T) with the physiological saline supply line 8 in the blood circuit to the tip of the arterial blood circuit 1 is converted into a physiological saline (substitution fluid). As shown in FIG. 3, the electromagnetic valve V1 (arterial valve means) is opened and the electromagnetic valve V2 (venous valve means) is closed, and the electromagnetic valve V3 is returned. (Switching means) is closed and the blood pump 4 is driven in reverse.

  In this first arterial blood return step S4, a predetermined amount of the blood from the connection portion (position of the T-shaped tube T) with the physiological saline supply line 8 in the blood circuit to the tip of the venous blood circuit 2 is physiologic. The blood will be returned to blood after being replaced with a saline solution (substitution solution). Here, in the present embodiment, it is determined whether or not the artery-side bubble detection means 10 has detected a bubble in the course of the artery-side blood return step S4 (S5). If the arterial bubble detection means 10 does not detect a bubble in S5, it is determined whether or not the physiological saline solution supplied in the first arterial blood return step S4 has reached a predetermined volume (S6). If it is determined that the capacity has been reached, the first arterial blood return step S4 ends, and the process proceeds to S7. The predetermined amount in S6 can be grasped by detecting the driving time or flow rate of the blood pump 4, for example.

  S7 is a step of determining whether or not the blood return to the blood circuit (the arterial blood circuit 1 and the venous blood circuit 2) has reached a predetermined amount (that is, whether or not a predetermined amount of replacement fluid has been delivered). If it is determined that the predetermined blood return amount has not been reached, the process proceeds to S9, in which whether or not the blood return to the venous blood circuit 2 has reached a predetermined amount (that is, the predetermined amount of replacement liquid is delivered). Or not). If it is determined in S9 that the amount of blood returned to the venous blood circuit 2 has not reached the predetermined value, the process returns to S1 and the venous blood returning step S1 is performed. In S9, the venous blood circuit 2 is returned. When it is determined that the amount of blood returned to the predetermined value has reached a predetermined value, the process returns to S3 to perform the pressure accumulation step S3 and the arterial blood return step S4.

  On the other hand, when it is determined in S9 that both the blood return amounts for the arterial blood circuit 1 and the venous blood circuit 2 have reached a predetermined value, a series of control for blood return ends. In other words, in the present embodiment, the control means 19 causes the venous blood return step S1 and the arterial blood return step S4 to be alternately performed a plurality of times. By performing the blood process S4 a predetermined number of times, all blood in the blood circuit is set to be replaced with physiological saline (substitution liquid).

  By the way, in this embodiment, when the artery side bubble detection means 10 detects a bubble in S5, it controls to transfer to recovery process S8. The recovery step S8 is performed on the condition that the arterial bubble detection means 10 detects a bubble at the time of the arterial blood return step S4, and the detected bubble is transferred to the blood pump 4 side from the connecting portion (position of the T-shaped tube T). This is a step of shifting to the venous blood return step S1. Note that the blood pump 4 is temporarily stopped and the solenoid valve V1 is closed after the artery side bubble detection means 10 detects the bubble and before the recovery process S8 is started, and the physiological saline (substitution fluid) and the bubble are closed. It is preferable to control the flow of the air to stop.

  In the recovery step S8, as shown in FIG. 4, the electromagnetic valve V1 (arterial valve means) and the electromagnetic valve V2 (venous valve means) are opened, and the electromagnetic valve V3 (switching means) is closed. Then, the blood pump 4 is slightly forward driven. The forward rotation of the blood pump 4 at this time is such that the bubbles detected by the arterial-side bubble detection means 10 are connected from the position where the arterial-side bubble detection means 10 is connected to the physiological saline supply line 8 (T-shaped tube). It is set to such an extent that it flows from the T position) to the blood pump 4 side. Since the dimension from the position where the arterial bubble detection means 10 is arranged in the blood circuit to the connection portion (position of the T-tube T) with the physiological saline supply line 8 is known, the blood at the time of the recovery step S8 The driving amount of the pump 4 can be grasped in advance.

  When the recovery process S8 is completed, the process proceeds to the venous return process S1, and at the time of the transferred venous return process S1, the arterial air bubbles are detected in the arterial air trap chamber 5 or the venous air trap chamber 6. The bubbles detected by the means 10 are captured. Thus, even if the arterial bubble detection means 10 detects a bubble during the arterial blood return step S4, the recovery step S8 can automatically cope with it without issuing an alarm. If the arterial blood return step S1 has already been completed a predetermined number of times when the arterial air bubble detection means 10 detects the air bubble, the apparatus does not proceed to the recovery step S8 but issues an alarm to stop the apparatus. Controlled.

  Instead of the above control, as shown in FIG. 6, after the recovery step S8, whether or not the blood return to the venous blood circuit 2 has reached a predetermined amount in S10 (that is, a predetermined amount of replacement liquid is If it is determined that the amount of blood returned to the venous blood circuit 2 has not reached the predetermined value, the process returns to S1 and the venous blood returning step S1 is performed. In addition, if it is determined that the amount of blood returned to the venous blood circuit 2 has reached a predetermined value, the flow may return to S4 to perform the arterial blood return step S4. Thus, even when the venous blood return step S1 has already been completed when the arterial air bubble detection means 10 detects the air bubbles, the arterial blood return step without issuing an alarm and stopping the device. S4 can be performed.

  Further, in the final stage of blood return (after the venous return process S1 is performed a plurality of times), the recovery process S8 and the venous return process S1 (which may be either process) When the blood pump 4 is driven to rotate forward in the side blood return step S1, a physiological saline solution (replacement solution) that has already been replaced with blood is introduced into the patient's body, causing a problem. In order to avoid such a problem, for example, at the time of the venous blood return step S1, as shown in FIG. 7, the electromagnetic valves V1 and V2 are closed (however, the electromagnetic valve V2 may be open). The electromagnetic valve V3 is opened, the blood pump 4 is driven to rotate forward, the electromagnetic valve of the dialysate introduction line La is closed, the electromagnetic valve of the dialysate discharge line Lb is opened, and the water removal pump 18 is turned on. You may make it drive at equal speed. In the recovery step S8 at the end of blood return (after the venous side blood return step S1 is performed a plurality of times), the electromagnetic valves V2 and V3 are closed while the electromagnetic valve V1 is open, and the blood pump 4 , The electromagnetic valve of the dialysate introduction line La is closed, and the electromagnetic valve of the dialysate discharge line Lb is opened, so that the water removal pump 18 is driven at a constant speed. As a result, even when the venous blood return step S1 has already been completed when the arterial air bubble detection means 10 detects the air bubbles, the venous blood return without issuing an alarm and stopping the device. Step S1 can be performed.

  According to this embodiment, the control means 19 can perform the recovery step S8 for driving the blood pump 4 to rotate forward on the condition that the arterial bubble detection means 10 has detected a bubble when returning blood. When air bubbles are detected during blood, the movement direction of the air bubbles can be automatically changed, and the burden on the medical staff can be reduced. In the present embodiment, at the recovery step S8, the blood pump 4 is driven to rotate forward so that the detected bubbles flow at least from the connecting portion (T-shaped tube T) to the blood pump 4 side, and then returned to the venous side. The process is shifted to the blood process S1, but a recovery process that drives the blood pump 4 to rotate forward is sufficient as long as the arterial bubble detection means 10 detects a bubble when returning blood.

  In particular, in the present embodiment, the blood pump 4 is driven to rotate forward on the condition that the arterial bubble detection means 10 has detected a bubble during the arterial blood return step S4, and the detected bubble is at least connected (T-shaped). Since the recovery step S8 is performed to move to the venous blood return step S1 after flowing from the position of the tube T to the blood pump 4 side, automatically when bubbles are detected during the arterial blood return step S4 It is possible to change the moving direction of the air bubbles and to suppress the warning due to the air bubble detection, thereby reducing the burden on the medical staff. In particular, in the present embodiment, in the recovery step S8, it is preferable to cause the detected bubbles to flow downstream (dialyzer 3 side) from the position where the blood pump 4 is arranged. Even in the case of reverse driving, the bubbles are likely to stay on the outlet side (downstream side) of the ironing tube 1a and flow upstream from the ironing tube 1a (tip side of the arterial blood circuit 1). Can be suppressed.

  In addition, the blood pump 4 can be driven forward and backward, and the control means 19 drives the blood pump 4 to rotate forward in the venous blood return step S1, and the blood pump 4 in the arterial blood return step S4. Therefore, the blood return by the venous blood return step S1 and the arterial blood return step S4 can be performed satisfactorily and reliably. Further, in the recovery step S8, the control means 19 according to the present embodiment opens the electromagnetic valve V1 (arterial side valve means) and the electromagnetic valve V2 (venous side valve means) and opens the electromagnetic valve V3 (switching means). Since it is in the closed state, when a bubble is detected in the arterial blood return step S4, the moving direction of the bubble can be automatically and smoothly changed.

  Furthermore, the control means 19 according to the present embodiment is configured to cause the venous side blood return step S1 and the arterial side blood return step S4 to be alternately performed a plurality of times and at the time of the arterial side blood return step S4. Since the recovery step S8 is performed on the condition that the bubble detection means 10 detects the bubble, in the blood return process, the connection from the physiological saline supply line 8 in the blood circuit to the tip of the venous blood circuit 2 is performed. Blood and blood from the connection with the physiological saline supply line 8 in the blood circuit to the tip of the arterial blood circuit 1 can be prevented from coagulating, and bubbles can be generated during the arterial blood return step S4. When the air bubble is detected, the moving direction of the bubbles can be automatically changed, and the burden on the medical staff can be reduced.

  In addition, an arterial blood circuit 1 downstream from the venous blood circuit 2 and blood pump 4 (dialyzer 3 side) includes an air trap chamber for defoaming (in this embodiment, the arterial air trap chamber 5 and Since the venous air trap chamber 6) is connected, air bubbles can be reliably captured by the air trap chamber (arterial air trap chamber 5 and venous air trap chamber 6) in the venous blood return step S1. . Note that only one of the arterial air trap chamber 5 and the venous air trap chamber 6 may be connected.

  Furthermore, in the present embodiment, switching means that can arbitrarily switch between a closed state in which the flow path of the physiological saline solution supply line 8 (substitution fluid supply line) is closed and a distribution state in which the physiological saline solution (substitution fluid) can be circulated. Is composed of an electromagnetic valve V3 disposed in the physiological saline supply line 8, and can be switched between a closed state and a flow state by opening and closing the electromagnetic valve V3, so that the physiological saline is accommodated. It can be easily applied to a configuration in which the housing means 9 is connected to the base end of the physiological saline supply line 8 and the physiological saline as a replacement liquid is supplied to the blood circuit by its own weight.

  However, although the switching means according to the present embodiment is composed of the electromagnetic valve V3 disposed in the physiological saline supply line 8, it may be replaced with that shown in FIG. That is, as shown in the figure, instead of the physiological saline supply line 8, a replacement fluid line having a distal end connected to the T-shaped tube T and a proximal end connected to the dialysate introduction line La in the dialyzer body B 22 (substitution liquid supply line), and an iron pump 23 (switching means) may be disposed in the middle of the line.

  In this case, the switching means that can arbitrarily switch between a closed state in which the flow path of the replacement fluid line 22 (substitution fluid supply line) is closed and a distribution state in which the physiological saline solution (substitution fluid) can be circulated is the replacement fluid line 22 (substitution fluid). The dialysis fluid can be switched between the closed state and the flow state by stopping or driving the squeezing pump 23, so that the dialysate is supplied to the dialyzer 3 (blood purification). By connecting the proximal end of the replacement liquid supply line 22 to the dialysate introduction line La for supplying to the means) and driving the squeezing type pump 23 (such as a replacement fluid pump), the dialysate as the replacement liquid is supplied to the blood circuit. It can be easily applied to the form of supply.

  Furthermore, as shown in FIG. 9, the present invention can be applied to a device that does not include a replacement liquid supply line (physiological saline supply line 8) and switching means (electromagnetic valve V3 or ironing pump 23) as in the above embodiment. In this case, when blood is returned, as shown in the figure, the solenoid valves V1 and V2 are opened, the solenoid valve V6 of the dialysate introduction line La is opened, and the solenoid valve V5 of the dialysate discharge line Lb is opened. Is closed, and the blood pump 4 is driven reversely while the dual pump 17 is driven, so that the dialysate from the dialysate introduction line La is reversely filtered to the blood circuit side, and the dialyzed solution (substitution) Fluid) can be replaced with blood.

  At the time of returning the blood, the driving amount (flow rate) of the blood pump 4 is preferably set to about half of the driving amount (flow rate) of the dual pump 17, so that the dialyzed solution as the back-filtered replacement solution can be obtained. It flows to both the arterial blood circuit 1 and the venous blood circuit 2, and the arterial blood return process and the venous blood return process can be performed simultaneously. In addition, the driving amount (flow rate) of the blood pump 4 is set substantially equal to the driving amount (flow rate) of the compound pump 17, and the arterial blood return step is performed, and the blood pump 4 is stopped and the venous blood return step. May be performed separately.

  In the case of returning blood by reverse filtration as described above, when the arterial bubble detection means 10 detects a bubble, as shown in FIG. 10, the blood pump 4 is driven forward to perform the recovery process. Can do. In such a recovery step, it is preferable that the air bubbles detected by the arterial air bubble detection means 10 are moved downstream from the blood pump 4 (dialyzer 3 side). Even in the recovery step in this case, when bubbles are detected during blood return, the movement direction of the bubbles can be automatically changed, and the burden on the medical staff can be reduced.

  As mentioned above, although this embodiment was described, this invention is not limited to this, For example, the pressure accumulation process S3 is made unnecessary by arrange | positioning drive sources, such as an iron pump, in the middle of a substitution liquid supply line. You may make it do. In the present embodiment, the blood pump 4 is driven in reverse during the arterial blood return step S4. Instead, for example, a driving source such as an iron pump is provided in the middle of the replacement fluid supply line. In addition, the above-described iron pump performs the same operation as described above, or the physiological saline (replacement liquid) in the storage means 9 using the potential energy generated based on the installation height of the storage means 9. ) May be supplied into the blood circuit. In this embodiment, the present invention is applied to a dialysis apparatus used at the time of dialysis treatment, but is used in another apparatus that can purify the patient's blood while circulating it outside the body (for example, blood filtration dialysis, blood filtration, AFBF). The present invention may be applied to blood purification devices, plasma adsorption devices, and the like.

  Other functions are added as long as the blood purification device is equipped with a control unit that can perform a recovery step of driving the blood pump in a forward direction on condition that the arterial bubble detection unit detects a bubble when returning blood. The present invention can also be applied.

1 Arterial blood circuit 2 Venous blood circuit 3 Dialyzer (blood purification means)
4 Blood Pump 5 Arterial Air Trap Chamber 6 Vein Side Air Trap Chamber 7 Air Trap Chamber 8 Saline Solution Supply Line (Substitution Solution Supply Line)
DESCRIPTION OF SYMBOLS 9 Storage means 10 Arterial side bubble detection means 11 Vein side bubble detection means 12, 13 Blood discriminator 14, 15, 16 Tube detector 17 Duplex pump 18 Dewatering pump 19 Control means 20 Overflow line 21 Pressure sensor 22 Replenishment line (replacement) Liquid supply line)
23 Ironing type pump (switching means)
V1 Arterial valve means V2 Venous valve means V3 Solenoid valve (switching means)

The invention according to claim 1 is composed of an arterial blood circuit and a venous blood circuit, a blood circuit capable of extracorporeally circulating a patient's blood from the tip of the arterial blood circuit to the tip of the venous blood circuit, and the blood A blood purification means for purifying blood flowing between the arterial blood circuit and the venous blood circuit of the circuit, and disposed in the arterial blood circuit to drive the liquid in the blood circuit A blood pump that can flow in a direction, an artery-side bubble detecting means that is disposed in the vicinity of the tip of the artery-side blood circuit, and that can detect bubbles in the liquid flowing in the flow path, and after treatment, the replacement fluid is the blood A control means capable of supplying the circuit and replacing the blood in the blood circuit with the replacement liquid to return the blood; an arrangement position of the blood pump in the arterial blood circuit and a tip of the arterial blood circuit Connected between and blood A replacement liquid supply line capable of supplying a replacement liquid for replacing the blood in the circuit to the blood circuit on the artery side, a closed state for closing the flow path of the replacement liquid supply line, and a flow state for allowing the replacement liquid to flow In the blood purification apparatus comprising the switching means that can arbitrarily switch between , the control means is a recovery that drives the blood pump to perform normal rotation on the condition that, when returning blood, the arterial bubble detection means detects a bubble. The control means replaces the blood from the connection with the replacement liquid supply line in the blood circuit to the tip of the venous blood circuit with the replacement liquid when returning blood. An arterial that returns blood by substituting blood from the connecting portion of the blood circuit to the tip of the arterial blood circuit with the replacement fluid. And the recovery step was detected by driving the blood pump in a forward direction on the condition that the arterial bubble detection means detected a bubble during the arterial return step. It is a step of causing the air bubbles to flow at least from the connecting portion to the blood pump side and then shifting to the venous side blood return step .

According to a second aspect of the invention, the blood purification apparatus according to claim 1, wherein the blood pump, while being a normal rotation and reverse rotation can, said control means, said blood pump in the venous blood return step , And the blood pump is reversely driven in the arterial blood return step.

According to a third aspect of the present invention, in the blood purification apparatus according to the first or second aspect , the arterial valve is provided so that the vicinity of the tip of the arterial blood circuit can be opened and closed, and the flow path can be closed and opened. And a venous valve means that is provided so as to be capable of opening and closing the vicinity of the distal end of the venous blood circuit and capable of closing and opening the flow path, and the control means includes the artery in the recovery step. The side valve means and the vein side valve means are opened, and the switching means is closed.

According to a fourth aspect of the present invention, in the blood purification apparatus according to any one of the first to third aspects, the control means alternately performs the venous return step and the arterial return step multiple times. And the recovery step is performed on the condition that the arterial bubble detection means detects a bubble during the arterial blood return step.

According to a fifth aspect of the present invention, in the blood purification apparatus according to any one of the first to fourth aspects, the arterial blood circuit downstream of the venous blood circuit or the blood pump is defoamed. An air trap chamber is connected.

According to a sixth aspect of the present invention, in the blood purification apparatus according to any one of the first to fifth aspects, the switching means comprises an electromagnetic valve disposed in the replacement liquid supply line, and the electromagnetic valve It is possible to switch between the closed state and the distribution state by opening and closing.

According to a seventh aspect of the present invention, in the blood purification apparatus according to any one of the first to fifth aspects, the switching means comprises a squeezing type pump disposed in the replacement liquid supply line, and The closed state and the flow state can be switched by stopping or driving the mold pump.

Further , on the condition that the arterial bubble detection means has detected the bubble during the arterial blood return step, the blood pump is driven to rotate forward, and after the detected bubble flows at least from the connecting portion to the blood pump side, the vein Since the recovery process is transferred to the side blood return process, when air bubbles are detected during the arterial blood return process, the movement direction of the air bubbles can be automatically changed, reducing the burden on medical personnel. be able to.

According to the invention of claim 2 , the blood pump can be driven forward and backward, and the control means drives the blood pump forward in the venous side blood return step, and blood in the arterial side blood return step. Since the pump is driven in reverse, the blood return by the venous side blood return step and the arterial side blood return step can be performed satisfactorily and reliably.

According to the invention of claim 3 , since the control means opens the arterial valve means and the venous valve means and closes the switching means in the recovery process, air bubbles are generated during the arterial blood return process. When detected, the moving direction of the bubbles can be changed automatically and smoothly.

According to the invention of claim 4 , the control means causes the venous side blood return step and the arterial side blood return step to be alternately performed a plurality of times, and the arterial side bubble detection means during the arterial side blood return step. Since the recovery process is performed on the condition that air bubbles have been detected, the blood from the connection with the replacement liquid supply line in the blood circuit to the tip of the venous blood circuit in the blood return process, and the replacement liquid in the blood circuit It is possible to prevent blood from coagulating from the connection with the supply line to the tip of the arterial blood circuit, and automatically move the air bubbles when air bubbles are detected during the arterial blood return process The direction can be changed, and the burden on the medical staff can be reduced.

According to the invention of claim 5 , since the air trap chamber for defoaming is connected to the venous blood circuit or the arterial blood circuit downstream from the blood pump, in the venous blood return step, the air Air bubbles can be reliably captured by the trap chamber.

According to the invention of claim 6 , the switching means is composed of an electromagnetic valve disposed in the replacement liquid supply line, and can be switched between a closed state and a flow state by opening and closing the electromagnetic valve. It can be easily applied to a configuration in which a storage means storing physiological saline is connected to the proximal end of the replacement liquid supply line, and physiological saline as a replacement liquid is supplied to the blood circuit by its own weight.

According to the seventh aspect of the present invention, the switching means includes the ironing type pump disposed in the replacement liquid supply line, and can switch between the closed state and the flow state by stopping or driving the ironing type pump. Therefore, the base of the replacement fluid supply line is connected to the dialysate introduction line for supplying dialysate to the blood purification means, and the peristaltic pump is driven so that the dialysate as the replacement fluid is supplied to the blood circuit. It can be easily applied to the form of supply.

The schematic diagram which shows the blood purification apparatus (at the time of a venous side blood return process) which concerns on embodiment of this invention. Schematic showing the blood purification device (at the time of pressure accumulation in the arterial blood return process) Schematic showing the blood purification device (at the time of blood return in the arterial blood return process) Schematic showing the blood purification device (during the recovery process) Flow chart showing control contents at the time of blood return in the blood purification apparatus The flowchart which shows the other control content at the time of blood return in the blood purification apparatus Schematic showing the blood purification device (during other recovery process and venous return process) The schematic diagram which shows the blood purification apparatus which concerns on other embodiment of this invention. Schematic diagram showing a blood purification apparatus according to a reference example Schematic showing the blood purification device (during the recovery process) according to the reference example

Furthermore, as shown in FIG. 9, a reference example that does not include the replacement liquid supply line (physiological saline supply line 8) and switching means (electromagnetic valve V3 or ironing pump 23) as in the above embodiment will be described . In this case, when blood is returned, as shown in the figure, the solenoid valves V1 and V2 are opened, the solenoid valve V6 of the dialysate introduction line La is opened, and the solenoid valve V5 of the dialysate discharge line Lb is opened. Is closed, and the blood pump 4 is driven reversely while the dual pump 17 is driven, so that the dialysate from the dialysate introduction line La is reversely filtered to the blood circuit side, and the dialyzed solution (substitution) Fluid) can be replaced with blood.

The control means is capable of performing a recovery step of driving the blood pump in the forward direction on condition that the arterial bubble detection means has detected a bubble when returning blood , and the control means A venous return process for replacing the blood from the connection with the replacement fluid supply line in the blood circuit to the tip of the venous blood circuit with the replacement fluid and the connection with the replacement fluid supply line in the blood circuit And the arterial blood return step of returning the blood from the tip to the tip of the arterial blood circuit with a replacement liquid, and the recovery step is performed when the arterial air bubble detection means is a bubble in the arterial blood return step. If the blood purification device is a step of causing the blood pump to normally rotate on the condition that the detected air bubbles are detected, causing the detected bubbles to flow at least from the connection portion to the blood pump side, and then shifting to the venous side blood return step. If It can be functions of the are applied to like those added.

Claims (8)

A blood circuit comprising an arterial blood circuit and a venous blood circuit, and capable of extracorporeally circulating the patient's blood from the distal end of the arterial blood circuit to the distal end of the venous blood circuit;
A blood purification means for purifying blood flowing between the arterial blood circuit and the venous blood circuit of the blood circuit and flowing through the blood circuit;
A blood pump disposed in the arterial blood circuit and capable of flowing the fluid in the blood circuit in a driving direction;
An artery-side bubble detection means that is disposed near the tip of the artery-side blood circuit and can detect bubbles in the liquid flowing in the flow path;
Control means for supplying a replacement fluid to the blood circuit after treatment, and replacing the blood in the blood circuit with the replacement fluid to return blood;
In the blood purification apparatus comprising
The blood purification apparatus, wherein the control means can perform a recovery step of driving the blood pump in a forward direction on condition that the arterial bubble detection means detects a bubble when returning blood. Connected between the position of the blood pump in the arterial blood circuit and the tip of the arterial blood circuit, and can supply a replacement fluid for replacing the blood in the blood circuit to the arterial blood circuit A replacement liquid supply line;
Switching means capable of arbitrarily switching between a closed state in which the flow path of the replacement liquid supply line is closed and a flow state in which the replacement liquid can flow;
And having
The control means is a venous-side blood return step for returning blood by replacing the blood from the connection portion with the replacement fluid supply line in the blood circuit to the tip of the venous blood circuit when returning blood. And the arterial blood return step of returning blood by replacing the blood from the connection with the replacement fluid supply line in the blood circuit to the tip of the arterial blood circuit with the replacement fluid, and the recovery The step is to rotate the blood pump forward on the condition that the arterial bubble detection means has detected a bubble during the arterial blood return step, and at least the detected bubble is moved to the blood pump side from the connection portion. 2. The blood purification apparatus according to claim 1, wherein the blood purification apparatus is a step of shifting to the venous blood return step after flowing.   The blood pump can be driven in forward rotation and reverse rotation, and the control means drives the blood pump in forward rotation in the venous blood return step and reverses the blood pump in the arterial blood return step. The blood purification apparatus according to claim 2, wherein the blood purification apparatus is driven. An arterial valve means provided near the distal end of the arterial blood circuit as being openable and closable and capable of closing and opening the flow path;
A venous valve means provided near the distal end of the venous blood circuit as being openable and closable and capable of closing and opening the flow path;
The control means, in the recovery step, opens the arterial valve means and the venous valve means and closes the switching means. 3. The blood purification apparatus according to 3.   The control means is configured to cause the venous side blood return step and the arterial side blood return step to be alternately performed a plurality of times, and the arterial side bubble detection means detects air bubbles during the arterial side blood return step. The blood purification apparatus according to any one of claims 2 to 4, wherein the recovery step is performed on the condition of   The air trap chamber for defoaming is connected to the venous blood circuit or the arterial blood circuit downstream from the blood pump. Blood purification device.   3. The switching means comprises an electromagnetic valve disposed in the replacement liquid supply line, and can be switched between the closed state and the flow state by opening and closing the electromagnetic valve. The blood purification apparatus as described in any one of -6.   The switching means comprises an ironing type pump disposed in the replacement liquid supply line, and is capable of switching between the closed state and the flow state by stopping or driving the ironing type pump. The blood purification apparatus according to any one of claims 2 to 6.

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