JP3066151B2 - Ascites treatment equipment - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an apparatus for treating ascites, and more particularly to an apparatus capable of filtering and concentrating ascites only by a head without using a pump.

[0002]

2. Description of the Related Art In recent years, ascites extracted from a patient with ascites due to cirrhosis or cancer is used to remove harmful components such as cancer cells and bacteria using a filter, and then a protein useful for a living body is concentrated using a concentrator. Therapeutic methods of returning patients by intravenous infusion have been widely used.

[0003] As an apparatus used for such treatment, there is known an ascites treatment apparatus comprising a filter connected to a pump for removing ascites and a concentrator for concentrating the ascites filtered by the filter (for example, ascites treatment apparatus). JP-A-51-140387).

[0004] The conventional apparatus usually includes a pump, a holding device for a filter and a concentrator, a pressure monitor for a processing circuit, an alarm device, and the like. Further, there has been proposed an apparatus which has a mechanism capable of automatically controlling a sampling speed of a pump in accordance with a living body's ascites discharging ability, and continuously performs processing while collecting ascites from a patient.

[0005]

Since the conventional ascites treatment apparatus is heavy and difficult to carry, it is difficult to move the apparatus in an emergency to easily and safely treat ascites. Was. When using such a device,
It is necessary to install the ascites treatment circuit and operate the pump after familiarizing the user with the safe use of the device. Further, since it is necessary to monitor the apparatus during the treatment of ascites, there is a problem that the operation is extremely burdensome for doctors and nurses who are extremely busy in treating and nursing patients. In addition, in the case of the conventional device, when the transmembrane pressure difference rises due to clogging of the filtration membrane, etc., if blood is mixed in the ascites, hemolysis is caused, and the filtered and concentrated ascites may be returned to the patient. Sometimes it was impossible.

SUMMARY OF THE INVENTION Accordingly, an object of the present invention is to provide an ascites treatment apparatus which solves the above-described problems of the conventional apparatus, can easily cope with an emergency, and can be safely implemented even by a non-expert. To provide.

[0007]

Means for Solving the Problems The present inventors have made intensive studies to solve the above problems, and as a result, ascites storage bag containing ascites collected from a patient, a filter, a concentrator, an ascites By connecting the collection bags in this order and installing them in this order so that there is a height difference, it is possible to treat ascites by the effect of gravity difference due to the head without using a pump. As a result of heading and further study, the present invention has been achieved.

[0008] That is, the apparatus of the present invention comprises a filter,
The concentrator and the ascites collection bag are connected in this order via a conduit, and the collection ascites discharge pipe discharged from the concentrator is provided with a flow rate adjusting means, and the ascites discharged from the ascites storage bag is dropped by a head. An ascites treatment device characterized by being configured to be filtered and concentrated.

Next, an embodiment of the present invention will be described with reference to the drawings. FIGS. 1 and 2 are explanatory views of the ascites treatment apparatus of the present invention. The ascites storage bag 1 containing the ascites collected, the filter 3, the concentrator 5, and the ascites collection bag 7 are connected and integrated by a conduit. Have been. A filter 3, a concentrator 5, and a bag 7 for collecting ascites are provided at lower positions from the ascites storage bag 1 in order to filter and concentrate ascites by the action of gravity difference due to the head.

[0010] In the present invention, the head means to provide a height difference between the ascites storage bag and the filter, the filter and the concentrator, the concentrator and the ascites collection bag and the waste liquid bag. The height difference between the ascites storage bag provided at the top and the ascites collection bag provided at the bottom is usually 2.5 m or less in a hospital room. A negative pressure may be applied to the portion where the filtrate is discharged from the concentrator by using an aspirator or the like which can be easily used in the hospital to increase the processing speed.

As a filter, useful substances in ascites, for example, proteins such as albumin and globulin are passed,
Hollow fibers that do not allow passage of harmful substances such as bacteria and cancer cells and are less likely to cause clogging are used. In particular, a filter having a built-in porous hollow fiber having a rejection of 450 angstrom particles measured by an internal pressure circulation method of 93% or less and a rejection of 2000 angstrom particles of 97% or more is preferably used. . If a filter having a built-in hollow fiber having a rejection of 450 angstrom particles of 93% or more is used, the filtration speed becomes slow, which is not preferable in practical use.

Although there is no particular limitation on the material of the hollow fiber, polysulfone, polyethylene, and the like can be industrially manufactured to have practical strength and pressure resistance and can be sterilized. , Polypropylene, polyvinyl alcohol, ethylene-vinyl alcohol copolymer and the like can be preferably used.

As a form of the filtration method of the filter, any of an external pressure method and an internal pressure method can be used. Here, the external pressure method is a method in which a liquid to be filtered flows from the outside of the hollow fiber to the inside of the hollow fiber, and the internal pressure method is a liquid to be filtered from the inside of the hollow fiber to the outside of the hollow fiber. It is a method of flowing toward.

[0014] The concentrator has a built-in condensing membrane that has a permeability of almost 67,000 of molecular weight but not permeated by albumin, but can pass through water and an electrolyte dissolved in it. Although there is no particular limitation, generally, hollow fibers can be preferably used. Further, as a material of the concentration membrane, since a concentrated membrane having practical strength and pressure resistance can be obtained, polysulfone, polyacrylonitrile, polyethylene, polypropylene, polyvinyl alcohol, ethylene-vinyl alcohol copolymer, and the like are used. It can be used preferably.

The flow rate adjusting means may be any means capable of stopping and adjusting the flow rate of the recovered ascites concentrated by the concentrator.
The flow rate adjusting means is used by being incorporated in a drip circuit or the like from the viewpoints that the structure is simple and inexpensive, that doctors and nurses are familiar with daily use, and that they are safe as medical materials. Roller clamps are preferably used. By changing the balance between the flow rate of the recovered ascites fluid and the flow rate of the ultrafiltrate by the flow rate adjusting means, the protein concentration of the recovered ascites fluid can be easily adjusted.

As a method of adjusting the flow rates of the recovered ascites and the ultrafiltrate, for example, a scale indicating the volume is provided on the ascites recovery bag and the waste liquid bag, and the volume of the recovered ascites and the ultrafiltrate are measured. And a method of adjusting the flow rate adjusting means while occasionally checking the volume of the assimilatory fluid, and placing the ascites collection bag and the waste liquid bag on a balance and checking the weight thereof occasionally. As another method, the drip chambers 11 and 12 are respectively provided in the conduit 6 for guiding the ascites collected by the concentrator to the ascites collection bag and the conduit 8 for guiding the ultrafiltrate from the concentrator to the waste bag. There is also a method of adjusting the flow rate adjusting means while observing the dripping speed of these drip chambers. This method is practical since doctors and nurses are proficient in reading the flow rate instantaneously at the drip speed of the drip chamber. Further, when the concentrator is used in an external pressure system as shown in FIG. 2, for example, a scale indicating the capacity is attached to the module cylinder of the concentrator, and usually, the flow rate adjusting means is closed and used to recover the predetermined volume Each time ascites accumulates between the module tube of the concentrator and the hollow fiber, a method of opening the flow rate control means and collecting the ascites collected in the ascites collection bag may be used.

The ascites storage bag and the ascites collection bag can aseptically collect or collect ascites collected from a patient, and can modify ascites and collected ascites collected from a patient. There is no limitation on the material and shape as long as no harmful substances are eluted into the material and sterilizable. In the case of a blood bag made of soft PVC, since the internal volume easily changes due to the pressure difference due to the head drop, the bag does not affect the pressure difference, and the height difference is directly applied to the filter or the concentrator. Can be usually preferably used.

The material and the shape of the waste liquid bag are not limited as long as it can store the ultrafiltration liquid.
Usually, a soft PVC blood bag can be preferably used.

The conduit is ascites collected from the patient, filtered ascites,
There is no limitation on the material and shape of the ascites as long as it does not denature the collected ascites or elute harmful substances into them and can be sterilized. Usually, a blood circuit made of PVC can be preferably used from the viewpoint of safety.

[0020]

EXAMPLES The present invention will be described in more detail with reference to the following Examples, but it should not be construed that the invention is limited thereto. Examples 1 and 2 Pseudo ascites was treated using an ascites treatment apparatus as shown in FIG. As the ascites storage bag, ascites collection bag, and waste liquid bag, a commercially available PVC blood bag was used. Each conduit used a part of a commercially available PVC blood circuit. The drip chamber and the roller clamp used also came with a commercially available drip circuit. The filter has a rejection of 450 angstrom particles measured by the internal pressure circulation method,
The rejection of particles of 00 Angstroms is 79
%, 100% (Example 1), 0.8% and 99% (Example 2) of polysulfone hollow fibers with a membrane area of 0.6 m
↑ 2 The built-in one was used. The concentrator has a rejection of 99% for albumin and a transmission of 9 for inulin having a molecular weight of 5000.
A 6% polysulfone hollow fiber is coated with a membrane area of 1.3 m @ 2.
The built-in one was used. Bovine plasma having a total protein concentration of 3.0 g / dl was used for the simulated ascites fluid. The head is 70 cm between the ascites storage bag and the filter, 70 cm between the filter and the concentrator,
The distance between the concentrator and the bag for collecting ascites was 30 cm.

After setting as described above, the three-way cock 13 was opened to the physiological saline 14 side, and the inside of the circuit and the inside and outside of the hollow fibers of the filter and the concentrator were washed with physiological saline. Next, the three-way cock was opened to the ascites storage bag side, and pseudo ascites was flushed. The flow rates of the recovered ascites and the ultrafiltrate coming out of the concentrator were set by visually adjusting a roller clamp. When the pseudo ascites disappeared, the experiment was terminated, the treatment time required for ascites treatment, the amount of ascites fluid collected, and the total protein concentration of the ascites fluid were measured, and the total protein recovery was calculated. Table 1 shows the results.

[0022]

[Table 1]

When 3 liters of pseudo ascites is used, the processing time in Example 1 is 75 minutes, and the processing time in Example 2 is 4 minutes.
It can be processed in 5 minutes, and achieves the processing time within 2 hours desired in the field of ascites treatment. Further, the total protein recovery was 87% or more, which was sufficient for ascites treatment.

[0024]

As described above, the apparatus for treating ascites of the present invention does not use a pump, so that it can easily and safely perform treatment at any place. Also, there is no need to purchase a special processing device equipped with a pump or the like, which is economical. In addition, since the ascites is filtered and concentrated by the action of gravity due to the head, no excessive pressure is applied to the processing circuit, and even if blood is mixed in the ascites, it is safely processed without hemolysis. It is possible.

[Brief description of the drawings]

FIG. 1 is an explanatory diagram of the device of the present invention.

FIG. 2 is an explanatory view showing another embodiment of the device of the present invention.

FIG. 3 is an explanatory diagram of an apparatus used in an example.

[Explanation of symbols]

 REFERENCE SIGNS LIST 1 ascites storage bag 2, 4, 6, 8 conduit 3 filter 5 concentrator 7 ascites collection bag 9 waste liquid bag 10 flow control means 11, 12 drip chamber 13 three-way cock 14 physiological saline

Claims (1)

(57) [Claims] 1. A filter, a concentrator, and a bag for recovering ascites are connected in this order via a conduit so as to have a height difference sequentially from an ascites storage bag provided at an upper portion, and the ascites storage bag is discharged from the concentrator. An ascites treatment device, wherein a flow rate adjusting means is provided in the collected ascites outlet pipe, and ascites discharged from the ascites storage bag is filtered and concentrated by a head.