A pre-flushing method for a combined artificial kidney circuit

Abstract

A pre-flushing method for a combined artificial kidney pipeline, the combined artificial kidney pipeline includes a hemoperfusion device, a dialyzer, an arterial pipeline and a venous pipeline, and the pre-flushing method steps are as follows: a pre-flushing liquid is connected from the first end of the arterial pipeline to detect the liquid flow in the arterial pipeline; the difference between the liquid flow in the arterial pipeline and a preset flow value is calculated, if the difference between the liquid flow in the arterial pipeline and the preset flow value is greater than 0 and less than the preset flow difference, a separate pre-flushing mode is used to pre-flushing the combined artificial kidney pipeline, if the difference between the liquid flow in the arterial pipeline and the preset flow value is greater than or equal to the preset flow difference, a series pre-flushing mode is used to pre-flushing the combined artificial kidney pipeline. The present invention determines the pre-flushing mode according to the liquid flow in the combined artificial kidney pipeline, facilitates the combined artificial kidney pipeline to be pre-flushed in an appropriate pre-flushing mode, improves the pre-flushing efficiency, and simplifies the operation of pipeline pre-flushing.

Description

Technical Field

[0001] The invention belongs to the technical field of blood purification, and in particular relates to a pre-flushing method for a combined artificial kidney pipeline. Background Art

[0002] Blood purification is to draw blood out of the body and use a blood purifier to remove pathogen-related molecules in the blood, so as to purify the blood and treat diseases. According to the specific principles of blood purification, blood purification can be divided into treatment modes such as hemodialysis, hemofiltration, hemoperfusion, and plasma exchange. Each blood purification treatment mode is suitable for different clinical symptoms. At present, blood purification has been applied in many departments such as nephrology, neurosurgery, hematology, respiratory disease, liver disease, ICU, etc., and has achieved good clinical treatment results.

[0003] Combined artificial kidneys are widely used in the treatment of uremia. Combined artificial kidneys mainly connect dialyzers and hemoperfusion devices in series. During the treatment process, they can remove toxins and excess water in the patient's body, replenish the body's required substances, and maintain the patient's body's electrolyte and acid-base balance. Before the patient undergoes blood purification treatment, the blood purification treatment circuit, that is, the combined artificial kidney circuit, needs to be pre-flushed to ensure the safety of blood purification treatment. The pre-flushing of the combined artificial kidney circuit is to transfer a pre-flushing fluid such as physiological saline into the combined artificial kidney circuit. In the process of the pre-flushing fluid filling the circuit and flowing in the circuit, the impurities in the circuit are cleaned and the air in the circuit is removed. Pre-flushing is an essential step in the blood purification treatment process. If the circuit is not pre-flushed sufficiently, residual gas or impurities in the circuit will affect the safety of the patient's blood purification treatment.

[0004] The combined artificial kidney includes two blood purifiers, a dialyzer and a hemoperfusion device. The internal structures of these two devices are different, and the connecting pipelines between the devices are complicated. In order to ensure a good cleaning effect, the combined artificial kidney pipeline is usually pre-flushed separately, that is, flushing the dialyzer separately and flushing the hemoperfusion device separately. However, this pre-flushing method is relatively inefficient and not flexible enough, which is not conducive to the promotion and application of combined artificial kidney treatment. Summary of the invention

[0005] The object of the present invention is to provide a pre-flushing method for a combined artificial kidney pipeline which is simple to operate, has good pre-flushing effect and high efficiency.

[0006] In order to achieve the above object, the present invention adopts the following technical solutions:

[0007] A pre-flushing method for a combined artificial kidney circuit, the combined artificial kidney circuit comprising a hemoperfusion device, a dialyzer, an arterial circuit and a venous circuit, the second end of the arterial circuit being connected to a first bypass branch and a second bypass branch via a first joint, the second bypass branch being connected to the hemoperfusion device and a third bypass branch in sequence, the first bypass branch being connected to the third bypass branch and a fourth bypass branch via a second joint, the fourth bypass branch being connected to the dialyzer and the venous circuit in sequence, and the third bypass branch being connected to a fifth bypass branch;

[0008] The pre-flushing method comprises the following steps:

[0009] S1, connecting the priming liquid from the first end of the arterial line to detect the liquid flow in the arterial line;

[0010] S2, calculating the difference between the liquid flow in the arterial line and the preset flow value, if the difference between the liquid flow in the arterial line and the preset flow value is greater than 0 and less than the preset flow difference, pre-flushing the combined artificial kidney line in a separate pre-flushing mode, if the difference between the liquid flow in the arterial line and the preset flow value is greater than or equal to the preset flow difference, pre-flushing the combined artificial kidney line in a series pre-flushing mode;

[0011] In the single pre-flushing mode, the pre-flushing liquid is controlled to sequentially pass through the arterial line, the second bypass branch, the hemoperfusion device, the third bypass branch and the fifth bypass branch until the waste liquid bag, so as to pre-flushing the hemoperfusion device; or, the pre-flushing liquid is controlled to sequentially pass through the arterial line, the first bypass branch, the fourth bypass branch, the dialyzer and the venous line until the waste liquid bag, so as to pre-flushing the dialyzer;

[0012] In the series pre-flush mode, the pre-flush liquid is controlled to pass through the arterial line, the second bypass branch, the blood perfusion device, the third bypass branch, the fourth bypass branch, the dialyzer and the venous line in sequence, until the waste liquid bag, so as to perform a joint pre-flush on the blood perfusion device and the dialyzer.

[0013] Furthermore, when pre-flushing is performed in the series pre-flushing mode, a pipeline blockage detection step is also included:

[0014] S3, detecting the liquid flow rate of the second bypass flow branch to obtain a first detection flow rate;

[0015] S4, detecting the liquid flow rate of the venous line to obtain a second detection flow rate;

[0016] S5. Determine whether the combined artificial kidney pipeline is blocked based on the difference between the first detected flow rate and the second detected flow rate.

[0017] Furthermore, when pre-flushing is performed in the series pre-flushing mode, a leakage fault detection step of the hemoperfusion device and / or a leakage fault detection step of the dialyzer is also included:

[0018] The hemoperfusion device comprises the following steps of detecting a liquid leakage fault: detecting a liquid flow rate in the second bypass flow branch and a liquid flow rate in the third bypass flow branch, and calculating a difference between the liquid flow rate in the second bypass flow branch and the liquid flow rate in the third bypass flow branch; when the difference between the liquid flow rate in the second bypass flow branch and the liquid flow rate in the third bypass flow branch is greater than a first leakage judgment threshold, it is considered that the hemoperfusion device has a liquid leakage fault;

[0019] The steps for detecting leakage fault of the dialyzer are as follows: detecting the liquid flow in the fourth bypass branch and the liquid flow in the venous line, and calculating the difference between the liquid flow in the fourth bypass branch and the liquid flow in the venous line; when the difference between the liquid flow in the fourth bypass branch and the liquid flow in the venous line is greater than a second leakage judgment threshold, it is considered that the dialyzer has a leakage fault.

[0020] Furthermore, when pre-flushing is performed in the series pre-flushing mode, the following steps are also included:

[0021] S3', recording the time during which the priming fluid in the arterial line continues to flow;

[0022] S4', if the priming liquid in the arterial line continues to flow for a time greater than the pre-flushing stop prompt time, a pre-flushing stop prompt message is issued;

[0023] The pre-rinse stop prompt time is determined by the following method:

[0024] a. Calculate the total capacity of the combined artificial kidney circuit according to the blood chamber capacity of the hemoperfusion device and the blood chamber capacity of the dialyzer. The total capacity of the combined artificial kidney circuit = the blood chamber capacity of the hemoperfusion device + the blood chamber capacity of the dialyzer;

[0025] b. Determine the pre-flush stop reminder time based on the total capacity of the combined artificial kidney circuit and the liquid flow in the arterial circuit.

[0026] Furthermore, when the priming liquid in the arterial line continues to flow for a time greater than the pre-flushing stop prompt time, the amount of bubbles in the venous line is detected, and if there are no bubbles in the venous line, the pre-flushing is stopped.

[0027] Furthermore, when pre-flushing is performed in the series pre-flushing mode or in the separate pre-flushing mode, the temperature of the liquid in the arterial line is detected, and if the detected temperature of the liquid in the arterial line is lower than a preset temperature, a temperature alarm signal is issued.

[0028] Furthermore, when pre-flushing is performed in the series pre-flushing mode, the liquid temperature in the arterial line and the liquid temperature in the venous line are detected, and the difference between the liquid temperature in the arterial line and the liquid temperature in the venous line is compared with a preset temperature difference. If the difference between the liquid temperature in the arterial line and the liquid temperature in the venous line is greater than the preset temperature difference, the liquid flow in the arterial line is increased.

[0029] Furthermore, the pre-rinsing process also includes a mode switching step:

[0030] When switching from the single pre-flushing mode to the series pre-flushing mode, increasing the liquid flow rate in the arterial line so that the difference between the liquid flow rate in the arterial line and the preset flow rate value reaches the preset flow rate difference value;

[0031] When switching from the series pre-flushing mode to the separate pre-flushing mode, the liquid flow in the arterial line is reduced so that the difference between the liquid flow in the arterial line and the preset flow value is less than the preset flow difference.

[0032] Further, when switching from the series pre-flushing mode to the separate pre-flushing mode, the blood chamber capacity of the hemoperfusion device and the dialyzer are compared, and if the blood chamber capacity of the hemoperfusion device is greater than the blood chamber capacity of the dialyzer, the pre-flushing liquid is controlled to sequentially pass through the arterial line, the second bypass branch, the hemoperfusion device, the third bypass branch and the fifth bypass branch until the waste liquid bag, so as to pre-flushing the hemoperfusion device;

[0033] If the blood chamber capacity of the hemoperfusion device is less than or equal to the blood chamber capacity of the dialyzer, the pre-flushing liquid is controlled to pass through the arterial line, the first bypass branch, the fourth bypass branch, the dialyzer and the venous line in sequence until the waste liquid bag, so as to pre-flush the dialyzer.

[0034] Furthermore, it also includes a circulatory pre-flushing mode, in which the pre-flushing liquid is controlled to circulate in a loop composed of the first bypass branch, the second bypass branch, the blood perfusion device, and the third bypass branch.

[0035] It can be seen from the above technical solutions that the present invention targets the structural characteristics of the combined artificial kidney circuit, determines the pre-flush mode according to the liquid flow rate in the arterial circuit of the combined artificial kidney circuit, and selects a separate pre-flush mode or a series pre-flush mode when the liquid flow rate in the arterial circuit meets different conditions, so that the combined artificial kidney circuit can be pre-flushed in an appropriate pre-flush mode, which simplifies the pre-flush operation, can ensure the pre-flush effect of the circuit, and is conducive to improving the pre-flush efficiency. The combined artificial kidney circuit after pre-flush has higher safety, which is conducive to the promotion and application of the combined artificial kidney treatment method in clinical treatment. BRIEF DESCRIPTION OF THE DRAWINGS

[0036] In order to more clearly illustrate the embodiments of the present invention, the drawings required for use in the embodiments or the description of the prior art will be briefly introduced below. Obviously, the drawings described below are only some embodiments of the present invention. For ordinary technicians in this field, other drawings can be obtained based on these drawings without paying any creative work.

[0037] Figure 1 Schematic diagram of a combined artificial kidney circuit according to an embodiment of the present invention;

[0038] Figure 2 Flow chart of the method of the present invention.

[0039] The specific implementation modes of the present invention are further described in detail below with reference to the accompanying drawings. DETAILED DESCRIPTION

[0040] The present invention is described in detail below in conjunction with the accompanying drawings. When describing the embodiments of the present invention in detail, for the convenience of explanation, the drawings representing the device structure will not be partially enlarged according to the general proportion, and the schematic diagram is only an example, which should not limit the scope of protection of the present invention. It should be noted that the drawings are simplified in form and use non-precise proportions, which are only used to facilitate and clearly assist in explaining the purpose of the embodiments of the present invention. At the same time, in the description of the present application, the terms "first", "second", etc. are only used to distinguish the description, and cannot be understood as indicating or implying relative importance or implicitly indicating the number of technical features indicated; the terms "positive", "negative", "bottom", "upper", "lower", etc. indicate the orientation or position relationship based on the orientation or position relationship shown in the drawings, which is only for the convenience of describing the present invention and simplifying the description, rather than indicating or implying that the device or element referred to must have a specific orientation, be constructed and operated in a specific orientation, and therefore cannot be understood as a limitation to the present invention.

[0041] In the description of the present invention, it should be noted that, unless otherwise clearly specified and limited, the terms "connected" and "connection" should be understood in a broad sense, for example, it can be a fixed connection, a detachable connection, or an integral connection; it can be a mechanical connection or an electrical connection; it can be a direct connection, or it can be indirectly connected through an intermediate medium, it can also be the internal connection of two elements, it can be a wireless connection, or it can be a wired connection. For ordinary technicians in this field, the specific meanings of the above terms in the present invention can be understood according to specific circumstances.

[0042] like Figure 1 As shown, the combined artificial kidney pipeline of this embodiment includes a blood perfusion device 1, a dialyzer 2, an arterial pipeline 3, a venous pipeline 4, a first bypass branch 5, a second bypass branch 6, a third bypass branch 7, a fourth bypass branch 8 and a fifth bypass branch 9. The second bypass branch 6, the first bypass branch 5 and the third bypass branch 7 are connected in sequence, and the second bypass branch 6 and the third bypass branch 7 are respectively connected to the input end and the output end of the blood perfusion device 1 to form a blood perfusion device circulation loop. The priming liquid is connected from the first end of the arterial pipeline 3, the second end of the arterial pipeline 3 is connected to the first bypass branch 5 and the second bypass branch 6 through the first connector 10, the other end of the first bypass branch 5 is connected to the fourth bypass branch 8 and the third bypass branch 7 through the second connector 11, the other end of the fourth bypass branch 8 is connected to the dialyzer 2, the other end of the dialyzer 2 is connected to the venous pipeline 4, and the other end of the venous pipeline 4 is connected to a waste liquid bag (not shown). One end of the fifth bypass branch 9 is connected to the third bypass branch 7 and communicates with the third bypass branch 7, and the other end of the fifth bypass branch 9 is connected to the waste liquid bag 12. The fifth bypass branch 9 of this embodiment is connected to the third bypass branch 7 through the third joint 13. In other embodiments, the fifth bypass branch 9 can also be connected to the connection between the third bypass branch 7, the first bypass branch 5 and the fourth bypass branch 8 through a four-way joint or a four-way valve. The joint in the pipeline of the present invention can be a valve joint with a pipeline on-off control function, such as a three-way valve, a four-way valve, etc., or it can be a joint that only has a pipeline connection function, such as a three-way joint, a four-way joint, etc. When it is a joint that only has a pipeline connection function, a control valve that controls the on-off of the pipeline, such as a water stop clamp Q, etc., can be separately set on each bypass branch. By controlling the on-off of the pipeline through the control valve, the flow state of the liquid in the pipeline can be controlled.

[0043] The hemoperfusion device and dialyzer in the combined artificial kidney pipeline of the present invention are both conventional hemoperfusion devices and dialyzers, and the present invention does not improve the structure of the hemoperfusion device and dialyzer. A hemoperfusion adsorbent is provided in the hemoperfusion device, and blood is introduced into the hemoperfusion device, and endogenous or exogenous toxins or pathogenic substances in the patient's blood are removed by the hemoperfusion adsorbent. A hollow fiber membrane is provided in the dialyzer, and blood is introduced into the dialyzer. The blood and dialysate are respectively on both sides of the hollow fiber membrane. The semipermeable membrane principle is used to remove various harmful and redundant metabolic wastes and excessive electrolytes in human blood from the body to correct the water electrolyte and acid-base balance in the blood.

[0044] The combined artificial kidney circuit includes not only blood purifiers such as hemoperfusion devices and dialyzers, but also various connecting lines, including bypass branches, arterial lines, venous lines, etc. In actual applications, the volume of the blood purifier is generally much larger than the volume of the connecting lines, and the internal structure of the blood purifier is relatively complex. Therefore, sufficient and efficient flushing of the blood purifier is a difficult point in the pre-flushing of the combined artificial kidney circuit.

[0045] In order to improve the efficiency of pre-flushing and ensure the effect of pre-flushing, the main idea of ​​the method of the present invention is to determine the pre-flushing mode based on the liquid flow in the arterial line. There are two pre-flushing modes: a single pre-flushing mode and a series pre-flushing mode. Among them, the single pre-flushing mode is to pre-flushing the hemoperfusion device or the dialyzer. The series pre-flushing mode refers to connecting the hemoperfusion device and the dialyzer in series, so that the pre-flushing liquid flows through the hemoperfusion device and the dialyzer in turn, and the hemoperfusion device and the dialyzer are pre-flushed together.

[0046] The pre-flushing method of the combined artificial kidney pipeline of the present invention is described below. Figure 2 As shown, the pre-flushing method of the combined artificial kidney circuit of the present invention comprises the following steps:

[0047] S1. Connect the priming liquid from the first end of the arterial line to detect the liquid flow in the arterial line; ultrasonic detection or other methods may be used to detect the liquid flow in the line;

[0048] S2. Calculate the difference between the liquid flow in the arterial line and the preset flow value, and determine whether to use a separate pre-flush mode or a series pre-flush mode based on the difference. When the difference between the liquid flow in the arterial line and the preset flow value is greater than 0 and less than the preset flow difference, use the separate pre-flush mode to pre-flush the combined artificial kidney line. When the difference between the liquid flow in the arterial line and the preset flow value is greater than or equal to the preset flow difference, use the series pre-flush mode to pre-flush the combined artificial kidney line.

[0049] The liquid flow rate can reflect the capacity of the priming liquid connected to the pipeline. During the pre-flushing process, the liquid flow rate must reach a certain value to flush the pipeline. If the liquid flow rate is too low, the priming liquid cannot achieve the pre-flushing function of the combined artificial kidney pipeline. Therefore, the liquid flow rate in the arterial pipeline must be greater than the preset flow rate value (liquid flow rate in the arterial pipeline>preset flow rate value) to achieve the normal pre-flushing function of the combined artificial kidney pipeline. The preset flow rate value is related to the volume of the blood purifier and the volume of each pipeline. In specific applications, the preset flow rate value can be set to any value between 5ml / min and 10ml / min (including the endpoint value). When the difference between the liquid flow rate in the arterial line and the preset flow rate value is less than the preset flow rate difference, it means that the priming liquid is insufficient to complete the pre-flushing of the hemoperfusion device and the dialyzer at the same time. At this time, the single pre-flushing mode is selected for pre-flushing; when the difference between the liquid flow rate in the arterial line and the preset flow rate value reaches the preset flow rate difference (liquid flow rate in the arterial line - preset flow rate value ≥ preset flow rate difference), the series pre-flushing mode can be used to pre-flushed the hemoperfusion device and the dialyzer together. In specific applications, the preset flow rate difference can be set to any value between 3ml / min and 5ml / min (including the endpoint value).

[0050] After the pre-flushing mode is determined according to the difference between the liquid flow rate in the arterial line and the preset flow rate value, the pre-flushing operation of the combined artificial kidney line is started according to the pre-flushing execution instruction of the user. When the pre-flushing mode is the separate pre-flushing mode, the user can choose whether to perform separate pre-flushing on the hemoperfusion device or the dialyzer, and perform the corresponding pre-flushing operation according to the pre-flushing execution instruction input by the user.

[0051] After the pre-flushing begins, in the single pre-flushing mode, the pre-flushing liquid has two circulation modes in the combined artificial kidney circuit: one is to flow only through the hemoperfusion device to pre-flushing the hemoperfusion device alone, and the other is to flow only through the dialyzer to pre-flushing the dialyzer alone. Figure 1 Taking the combined artificial kidney circuit shown in the figure as an example, in the single pre-flushing mode, the pre-flushing liquid is controlled to pass through the arterial circuit 3, the second bypass branch 6, the hemoperfusion device 1, the third bypass branch 7 and the fifth bypass branch 9 in sequence, until the waste liquid bag 12, so as to pre-flushing the hemoperfusion device 1; or the pre-flushing liquid is controlled to pass through the arterial circuit 3, the first bypass branch 5, the fourth bypass branch 8, the dialyzer 2 and the venous circuit 4 in sequence, until the waste liquid bag (not shown), so as to pre-flushing the dialyzer 2. In the single pre-flushing mode, only one of the hemoperfusion device and the dialyzer can be pre-flushed.

[0052] After the pre-flushing starts, in the serial pre-flushing mode, the priming liquid is controlled to sequentially pass through the arterial line 3, the second bypass branch 6, the hemoperfusion device 1, the third bypass branch 7, the fourth bypass branch 8, the dialyzer 2 and the venous line 4, until the waste liquid bag. In the serial pre-flushing mode, the hemoperfusion device and the dialyzer can be pre-flushed together by the priming liquid.

[0053] In the single pre-flush mode, since only the hemoperfusion device or dialyzer needs to be flushed, the liquid flow rate in the arterial line is smaller than that in the series pre-flush mode. For lines with the same cross-sectional area, the liquid flow rate is small, and the liquid flow rate is correspondingly small. The pre-flush liquid is retained in the line for a relatively longer time, which is conducive to fully flushing the line to ensure the flushing effect of the hemoperfusion device or dialyzer. In the series pre-flush mode, since the hemoperfusion device and the dialyzer need to be flushed together, more pre-flush liquid is required, so that the flushing of the hemoperfusion device and the dialyzer can be completed at the same time through one series pre-flush, which improves the pre-flush efficiency and helps save the pre-flush time of the combined artificial kidney line. The pre-flush mode is determined based on the liquid flow rate in the arterial line. When the liquid flow rate in the arterial line is greater than the preset flow rate value, a comparison is made based on the difference between the two and the preset flow rate difference. When the difference between the two is less than the preset flow rate difference, a separate pre-flush mode is selected to avoid the situation where the combined pre-flush of the hemoperfusion device and the dialyzer cannot ensure the cleaning effect. When the difference between the two reaches the preset flow rate difference, the hemoperfusion device and the dialyzer are pre-flushed together, thereby simplifying the pre-flush operation of the combined artificial kidney line, achieving a good pre-flush effect and improving efficiency.

[0054] The following is an explanation of a specific application example of the method of the present invention. Determine whether to use a separate pre-flushing mode or a series pre-flushing mode to pre-flushed the combined artificial kidney pipeline according to the difference between the liquid flow rate in the arterial pipeline and the preset flow rate value, so as to adopt the best pre-flushing method for the combined artificial kidney pipeline. The preset flow rate value of this embodiment is 5ml / min, and the preset flow rate difference is 5ml / min. When the liquid flow rate in the arterial pipeline is measured to be 8ml / min, the liquid flow rate in the arterial pipeline-the preset flow rate value=8-5=3ml / min, 5ml / min>3ml / min>0, then a separate pre-flushing mode is adopted for the combined artificial kidney pipeline, and the pre-flushing liquid is controlled to flow through the hemoperfusion device or dialyzer at 8ml / min to complete the pre-flushing of the combined artificial kidney pipeline.

[0055] If the measured liquid flow rate in the arterial line is 12 ml / min, the liquid flow rate in the arterial line - the preset flow rate value = 12-5 = 7 ml / min, 7 ml / min> 5 ml / min, then the series pre-flushing mode is adopted for the combined artificial kidney line, and the pre-flushing liquid is controlled to flow through the hemoperfusion device and the dialyzer in sequence at 12 ml / min to complete the pre-flushing of the combined artificial kidney line.

[0056] The method of the present invention utilizes the pipeline structure layout characteristics of the combined artificial kidney pipeline, and flexibly sets a separate pre-flushing mode or a series pre-flushing mode based on the liquid flow in the arterial pipeline, so that the combined artificial kidney pipeline can achieve different pre-flushing functions under appropriate liquid flow rates, and the operation is simple and convenient, and the pre-flushing efficiency of the combined artificial kidney pipeline is improved. The combined artificial kidney pipeline after pre-flushing can ensure the safety of blood flow, and improves the safety of patients undergoing combined artificial kidney treatment.

[0057] As an optional implementation, in the series pre-flushing mode, the pre-flushing method further includes a pipeline blockage detection step for determining whether the combined artificial kidney pipeline is blocked during the pre-flushing process. The pipeline blockage detection step is as follows:

[0058] S3, detecting the liquid flow rate of the second bypass branch 6 to obtain a first detection flow rate;

[0059] S4, detecting the liquid flow rate of the venous line 4 to obtain a second detection flow rate;

[0060] S5. Determine whether the combined artificial kidney pipeline is blocked based on the difference between the first detected flow rate and the second detected flow rate.

[0061] The liquid flow of the second bypass branch and the venous line can be measured by flow sensor 14. The first detection flow represents the capacity of the pre-flushing liquid connected to the combined artificial kidney pipeline, and the second detection flow represents the capacity of the waste liquid output by the combined artificial kidney pipeline. After the pre-flushing liquid flows through each branch, the hemoperfusion device, and the dialyzer, it is possible to judge whether the combined artificial kidney pipeline is blocked according to the difference between the first detection flow and the second detection flow. The blockage of the combined artificial kidney pipeline may be blockage inside the hemoperfusion device or inside the dialyzer, such as the blockage of the internal material causing the pre-flushing liquid to be unable to flow smoothly, or it may be blockage in each branch such as the third bypass branch or the fourth bypass branch, such as the branch causing the pre-flushing liquid to be unable to flow smoothly. When it is judged that there is blockage, a fault alarm signal can be issued to prompt relevant personnel to check the pipeline in time, eliminate the cause of the blockage, and ensure the safety of treatment.

[0062] Exemplarily, if under normal circumstances (that is, when the combined artificial kidney pipeline is not blocked), the priming liquid flow rate connected to the second bypass branch 6 and the priming liquid flow rate output by the venous pipeline 4 are equal or approximately equal, such as the difference between the liquid flow rate of the second bypass branch 6 and the liquid flow rate of the venous pipeline 4 is usually less than 3ml / min (blockage judgment threshold); when the difference between the first detection flow rate and the second detection flow rate is greater than or equal to 3ml / min (blockage judgment threshold), it means that the liquid flow rate of the venous pipeline 4 is obviously too small, and it is judged that the combined artificial kidney pipeline is blocked. Further, when it is judged that the combined artificial kidney pipeline is blocked, a fault alarm signal is issued to prompt the user to deal with the blockage fault of the combined artificial kidney pipeline in time.

[0063] As another optional implementation, in the series pre-flushing mode, the pre-flushing method further includes a leakage fault detection step of the hemoperfusion device and / or a leakage fault detection step of the dialyzer.

[0064] The steps for detecting the leakage fault of the hemoperfusion device are as follows: detecting the liquid flow rate in the second bypass branch 6 and the liquid flow rate in the third bypass branch 7 and calculating the difference between the two liquid flow rates. When the difference between the liquid flow rate in the second bypass branch 6 and the liquid flow rate in the third bypass branch 7 is greater than the first leakage judgment threshold, such as 1 ml / min, it is considered that the hemoperfusion device 1 has a leakage fault. When the priming liquid passes through the hemoperfusion device 1 and the dialyzer 2 in sequence, the liquid flow rate in the second bypass branch 6 represents the flow rate of the priming liquid connected to the hemoperfusion device 1, and the liquid flow rate in the third bypass branch 7 represents the flow rate of the priming liquid output by the hemoperfusion device 1; when the liquid flow rate in the second bypass branch 6 is significantly greater than the liquid flow rate in the third bypass branch 7, it indicates that the hemoperfusion device 1 has a leakage fault. It can be checked whether the hemoperfusion device has a leakage fault due to cracks in the shell of the hemoperfusion device or unstable pipe connection.

[0065] The steps for detecting the leakage fault of the dialyzer are as follows: detecting the difference between the liquid flow rate in the fourth bypass branch 8 and the liquid flow rate in the venous line 4. When the difference between the liquid flow rate in the fourth bypass branch 8 and the liquid flow rate in the venous line 4 is greater than the second leakage judgment threshold, such as 1 ml / min, it is considered that the dialyzer 2 has a leakage fault. The liquid flow rate in the fourth bypass branch 8 represents the flow rate of the priming liquid connected to the dialyzer 2, and the liquid flow rate in the venous line 4 represents the flow rate of the priming liquid output by the dialyzer 2. When the liquid flow rate in the fourth bypass branch 8 is significantly greater than the liquid flow rate in the venous line 4, it means that the dialyzer 2 has a leakage fault.

[0066] As another optional implementation, in the series pre-flushing mode, the pre-flushing method further includes the following steps:

[0067] S3', recording the time of continuous flow of the priming fluid in the arterial line 3;

[0068] S4', if the continuous flow time of the pre-flushing liquid is greater than the pre-flushing stop prompt time, a pre-flushing stop prompt message is issued. The function of issuing the pre-flushing stop message in this step is to provide a prompt, and the pre-flushing process is not actually stopped.

[0069] In the series pre-flushing mode, the flow rate of the pre-flushing liquid in the combined artificial kidney circuit will be relatively high. The duration of the liquid in the arterial circuit 3 indicates the duration of the combined artificial kidney circuit for combined pre-flushing. When the pre-flushing time is too long, the long-term flow of the pre-flushing liquid in the combined artificial kidney circuit does not improve the flushing effect, but only leads to the waste of the pre-flushing liquid and increases the cost. Therefore, by setting the pre-flushing stop prompt time to control the duration of the series pre-flushing mode, the waste of the pre-flushing liquid is avoided and the cost is reduced while ensuring the pre-flushing effect.

[0070] The pre-rinse stop reminder time can be determined by the following method:

[0071] a. According to the blood chamber capacity of the hemoperfusion device and the blood chamber capacity of the dialyzer, the total capacity of the combined artificial kidney circuit is obtained, and the total capacity of the combined artificial kidney circuit = the blood chamber capacity of the hemoperfusion device + the blood chamber capacity of the dialyzer; the blood chamber capacity of the hemoperfusion device refers to the maximum volume of liquid that the hemoperfusion device can accommodate, and the blood chamber capacity of the dialyzer refers to the maximum volume of liquid that the dialyzer can accommodate; since the hemoperfusion device is provided with resin material (hemoperfusion adsorbent), the blood chamber capacity of the hemoperfusion device is not equal to the volume of the hemoperfusion device, but is smaller than the volume of the hemoperfusion device; similarly, the dialyzer is provided with hollow fiber membranes, and the blood chamber capacity of the dialyzer is not equal to the volume of the dialyzer, but is smaller than the volume of the dialyzer;

[0072] b. Determine the pre-flushing stop prompt time according to the total capacity of the combined artificial kidney circuit and the liquid flow in the arterial circuit. The pre-flushing stop prompt time is proportional to the total capacity of the combined artificial kidney circuit and inversely proportional to the liquid flow in the arterial circuit. For example, when the total capacity of the combined artificial kidney circuit is larger and the liquid flow in the arterial circuit is smaller, the time for the combined pre-flushing of the hemoperfusion device and the dialyzer must be longer to achieve sufficient flushing of the hemoperfusion device and the dialyzer. At this time, the pre-flushing stop prompt time must be set longer; conversely, when the total capacity of the combined artificial kidney circuit is smaller and the liquid flow in the arterial circuit is larger, the time for the combined pre-flushing of the hemoperfusion device and the dialyzer must be shorter to avoid waste of the pre-flushing liquid. The pre-flushing stop prompt time can be set accordingly based on the total capacity of the combined artificial kidney circuit and the liquid flow in the arterial circuit according to experience, so as to make full use of the pre-flushing liquid and reduce waste on the basis of ensuring the flushing effect of the blood purifier. The pre-flushing stop prompt time can be determined more accurately and reasonably according to the total capacity of the combined artificial kidney circuit and the liquid flow in the arterial circuit.

[0073] Furthermore, when in the series pre-flush mode, when the continuous flow time of the pre-flush liquid is greater than the pre-flush stop prompt time, the amount of bubbles in the venous line is detected, and whether the pre-flush is completed is judged based on the amount of bubbles in the venous line. If the pre-flush is completed, the liquid flow in the arterial line is controlled to 0, and the pre-flush is stopped, thereby achieving the purpose of automatically stopping when the combined artificial kidney line is fully pre-flushed, thereby avoiding waste of pre-flush liquid.

[0074] When the amount of bubbles in the venous line is close to 0 or 0, it means that the line is fully flushed and the flushing can be stopped. When the amount of bubbles is greater than 0, it means that the line is not fully flushed. In specific applications, a bubble sensor 15 can be set on the venous line. The bubble sensor converts the detected amount of bubbles into a voltage, which is used to characterize the amount of bubbles in the venous line. If the voltage output by the bubble sensor is less than 1V, it means that there are no bubbles in the venous line or the bubbles are approximately 0 (negligible). At this time, the combined artificial kidney line has been pre-flushed, and the liquid flow in the arterial line is controlled to be 0, and the pre-flushing is stopped; when the voltage output by the bubble sensor is greater than or equal to 1V, it means that there are still bubbles in the venous line, and the pre-flushing liquid is not sufficient to flush the combined artificial kidney line. At this time, the user can decide whether to stop flushing or continue flushing.

[0075] Optionally, the pre-flushing process in the single pre-flushing mode or the tandem pre-flushing mode further includes a step of detecting the temperature of the liquid in the arterial line, and if the detected liquid temperature is lower than a preset temperature, a temperature alarm signal is issued.

[0076] When the combined artificial kidney circuit is pre-flushing, the temperature of the pre-flushing liquid in the arterial circuit will affect the pre-flushing effect of the combined artificial kidney circuit. For example, when the temperature of the pre-flushing liquid in the arterial circuit is too low (the liquid temperature is less than the preset temperature), the liquid with too low a temperature will not only damage the chemical properties of the resin material in the hemoperfusion device, but also fail to flush out the micro impurities in the hemoperfusion device and the micro impurities in the dialyzer. Only when the temperature of the pre-flushing liquid in the arterial circuit is maintained at a normal temperature (the liquid temperature is greater than or equal to the preset temperature), the liquid maintained at a normal temperature will not damage the chemical properties of the material, and the hemoperfusion device and the dialyzer can be fully flushed by the pre-flushing liquid. The preset temperature is an empirical value, which can generally be set to any value between 30°C and 33°C (including the endpoint value). By prompting the user to deal with the fault of too low temperature in time through the temperature alarm signal, it can prevent the pre-flushing liquid temperature from being too low, resulting in insufficient pre-flushing of the circuit, and has better pre-flushing effect and pre-flushing safety.

[0077] Optionally, in the series pre-flush mode, it also includes the steps of detecting the liquid temperature in the arterial line and detecting the liquid temperature in the venous line, comparing the difference between the liquid temperature in the arterial line and the liquid temperature in the venous line with a preset temperature difference, and adjusting the liquid flow in the arterial line according to the comparison result.

[0078] Generally speaking, compared with the single pre-flushing mode, the flow path of the pre-flushing liquid in the combined artificial kidney pipeline in the series pre-flushing mode is longer, and the flow time is also longer. The difference in the liquid temperature in the arterial pipeline and the venous pipeline is used to determine whether to adjust the liquid flow in the arterial pipeline. When the difference between the liquid temperature in the arterial pipeline and the liquid temperature in the venous pipeline is greater than the preset temperature difference, it means that the pre-flushing liquid has flowed through the combined artificial kidney pipeline for too long, and the flow rate of the pre-flushing liquid in the combined artificial kidney pipeline is too low, resulting in a significant drop in temperature during the flow of the pre-flushing liquid in the pipeline. At this time, the liquid flow rate in the arterial pipeline needs to be increased. In this case, by increasing the liquid flow rate in the arterial pipeline, the flow time of the pre-flushing liquid in the combined artificial kidney pipeline is shortened to reduce the temperature drop of the pre-flushing liquid in the combined artificial kidney pipeline, so as to avoid the problem of low efficiency of combined pre-flushing caused by too small liquid flow in the arterial pipeline. The liquid flow rate in the arterial pipeline is adjusted so that the difference between the liquid temperature in the arterial pipeline and the liquid temperature in the venous pipeline does not exceed the preset temperature difference. The temperature preset difference is an empirical value and can be summarized based on clinical application conditions.

[0079] During the pre-flushing process of the combined artificial kidney circuit, a mode switching step can be set, such as switching from a single pre-flushing mode to a series pre-flushing mode, or from a series pre-flushing mode to a single pre-flushing mode. When switching from a single pre-flushing mode to a series pre-flushing mode, increase the liquid flow in the arterial circuit so that the difference between the liquid flow in the arterial circuit and the preset flow value reaches the preset flow difference (liquid flow in the arterial circuit - preset flow value ≥ preset flow difference), so that the combined artificial kidney circuit can continue to pre-flushing in the series pre-flushing mode; when switching from the series pre-flushing mode to the single pre-flushing mode, lower the liquid flow in the arterial circuit so that the difference between the liquid flow in the arterial circuit and the preset flow value is less than the preset flow difference, so that the combined artificial kidney circuit can continue to pre-flushing in the single pre-flushing mode. By switching the modes, the needs of practical applications can be met.

[0080] Furthermore, when the combined artificial kidney circuit is switched from the series pre-flush mode to the separate pre-flush mode, the following steps are also included: comparing the blood chamber capacity of the hemoperfusion device and the blood chamber capacity of the dialyzer; if the blood chamber capacity of the hemoperfusion device is larger than that of the dialyzer, the pre-flush liquid is controlled to pass through the arterial circuit, the second bypass branch, the hemoperfusion device, the third bypass branch, the fifth bypass branch, and finally to the waste liquid bag in sequence, so as to perform a separate pre-flush on the hemoperfusion device; if the blood chamber capacity of the hemoperfusion device is less than or equal to the blood chamber capacity of the dialyzer, the pre-flush liquid is controlled to pass through the arterial circuit, the first bypass branch, the fourth bypass branch, the dialyzer, the venous circuit in sequence, and finally to the waste liquid bag, so as to perform a separate pre-flush on the dialyzer.

[0081] In the series pre-flushing mode, the priming liquid has been flushed through the hemoperfusion device and the dialyzer in sequence, and the hemoperfusion device and the dialyzer with a larger blood chamber capacity may have a slightly worse pre-flushing effect than the one with a smaller blood chamber capacity. Therefore, according to the blood chamber capacity of the hemoperfusion device and the dialyzer, it is judged whether to pre-flushing the hemoperfusion device or the dialyzer after switching to the separate pre-flushing mode, so as to ensure that the blood purifier can obtain a good flushing effect. For example, when the blood chamber capacity of the hemoperfusion device is greater than the blood chamber capacity of the dialyzer, it means that the hemoperfusion device requires more priming liquid (larger priming liquid capacity) than the dialyzer to flush, so after switching to the separate pre-flushing mode, only the hemoperfusion device is flushed separately; similarly, when the blood chamber capacity of the hemoperfusion device is less than or equal to the blood chamber capacity of the dialyzer, it means that the dialyzer requires more priming liquid than the hemoperfusion device to flush, so after switching to the separate pre-flushing mode, only the dialyzer is flushed separately. By comparing the blood chamber capacity of the hemoperfusion device and the blood chamber capacity of the dialyzer, it can be ensured that both the hemoperfusion device and the dialyzer are fully pre-flushed, while avoiding the waste of the pre-flushing fluid.

[0082] In some embodiments, the pre-flushing method of the present invention also includes a cyclic pre-flushing mode, which is used to perform a separate cyclic pre-flushing on the hemoperfusion device. During the clinical application of the combined artificial kidney pipeline, the hemoperfusion device may need to be replaced. When the hemoperfusion device needs to be pre-flushed after replacement, the hemoperfusion device can be pre-flushed through the cyclic pre-flushing mode. In the cyclic pre-flushing mode, the pre-flushing liquid is controlled to circulate in a loop composed of the first bypass branch, the second bypass branch, the hemoperfusion device, and the third bypass branch to fully flush the hemoperfusion device. In addition, the cyclic pre-flushing mode can also avoid the waste of pre-flushing liquid, which is conducive to improving the efficiency of separate pre-flushing of the hemoperfusion device.

[0083] The above description of the disclosed embodiments enables one skilled in the art to implement or use the present invention. Various modifications to these embodiments will be apparent to one skilled in the art, and the general principles defined herein may be implemented in other embodiments without departing from the spirit or scope of the present invention. Therefore, the present invention will not be limited to the embodiments shown herein, but rather to the widest scope consistent with the principles and novel features disclosed herein.

Claims

1. A pre-flushing method for a combined artificial kidney circuit, characterized in that: The combined artificial kidney pipeline comprises a hemoperfusion device, a dialyzer, an arterial pipeline and a venous pipeline, the second end of the arterial pipeline is connected to a first bypass branch and a second bypass branch via a first joint, the second bypass branch is connected to the hemoperfusion device and a third bypass branch in sequence, the first bypass branch is connected to the third bypass branch and a fourth bypass branch via a second joint, the fourth bypass branch is connected to the dialyzer and the venous pipeline in sequence, and the third bypass branch is connected to a fifth bypass branch; The pre-flushing method comprises the following steps: S1, connecting the priming liquid from the first end of the arterial line to detect the liquid flow in the arterial line; S2, calculating the difference between the liquid flow in the arterial line and the preset flow value, if the difference between the liquid flow in the arterial line and the preset flow value is greater than 0 and less than the preset flow difference, pre-flushing the combined artificial kidney line in a separate pre-flushing mode, if the difference between the liquid flow in the arterial line and the preset flow value is greater than or equal to the preset flow difference, pre-flushing the combined artificial kidney line in a series pre-flushing mode; In the single pre-flushing mode, the pre-flushing liquid is controlled to sequentially pass through the arterial line, the second bypass branch, the hemoperfusion device, the third bypass branch and the fifth bypass branch until the waste liquid bag, so as to pre-flushing the hemoperfusion device; or, the pre-flushing liquid is controlled to sequentially pass through the arterial line, the first bypass branch, the fourth bypass branch, the dialyzer and the venous line until the waste liquid bag, so as to pre-flushing the dialyzer; In the series pre-flush mode, the pre-flush liquid is controlled to pass through the arterial line, the second bypass branch, the blood perfusion device, the third bypass branch, the fourth bypass branch, the dialyzer and the venous line in sequence, until the waste liquid bag, so as to perform a joint pre-flush on the blood perfusion device and the dialyzer.

2. The pre-flushing method of the combined artificial kidney circuit as claimed in claim 1, characterized in that: When pre-flushing is performed in the series pre-flushing mode, a pipeline blockage detection step is also included: S3, detecting the liquid flow rate of the second bypass flow branch to obtain a first detection flow rate; S4, detecting the liquid flow rate of the venous line to obtain a second detection flow rate; S5. Determine whether the combined artificial kidney pipeline is blocked based on the difference between the first detected flow rate and the second detected flow rate.

3. The pre-flushing method of the combined artificial kidney circuit as claimed in claim 1, characterized in that: When pre-flushing is performed in the series pre-flushing mode, it also includes a leakage fault detection step of the hemoperfusion device and / or a leakage fault detection step of the dialyzer: The hemoperfusion device comprises the following steps of detecting a liquid leakage fault: detecting a liquid flow rate in the second bypass flow branch and a liquid flow rate in the third bypass flow branch, and calculating a difference between the liquid flow rate in the second bypass flow branch and the liquid flow rate in the third bypass flow branch; when the difference between the liquid flow rate in the second bypass flow branch and the liquid flow rate in the third bypass flow branch is greater than a first leakage judgment threshold, it is considered that the hemoperfusion device has a liquid leakage fault; The steps for detecting leakage fault of the dialyzer are as follows: detecting the liquid flow in the fourth bypass branch and the liquid flow in the venous line, and calculating the difference between the liquid flow in the fourth bypass branch and the liquid flow in the venous line; when the difference between the liquid flow in the fourth bypass branch and the liquid flow in the venous line is greater than a second leakage judgment threshold, it is considered that the dialyzer has a leakage fault.

4. The pre-flushing method of the combined artificial kidney circuit according to claim 1, characterized in that: When pre-flushing is performed in the series pre-flushing mode, the following steps are also included: S3', recording the time during which the priming fluid in the arterial line continues to flow; S4', if the priming liquid in the arterial line continues to flow for a time greater than the pre-flushing stop prompt time, a pre-flushing stop prompt message is issued; The pre-rinse stop prompt time is determined by the following method: a. Calculate the total capacity of the combined artificial kidney circuit according to the blood chamber capacity of the hemoperfusion device and the blood chamber capacity of the dialyzer. The total capacity of the combined artificial kidney circuit = the blood chamber capacity of the hemoperfusion device + the blood chamber capacity of the dialyzer; b. Determine the pre-flush stop reminder time based on the total capacity of the combined artificial kidney circuit and the liquid flow in the arterial circuit.

5. The pre-flushing method of the combined artificial kidney circuit as claimed in claim 4, characterized in that: When the priming liquid in the arterial line continues to flow for a time greater than the pre-flushing stop prompt time, the amount of bubbles in the venous line is detected, and if there are no bubbles in the venous line, the pre-flushing is stopped.

6. The pre-flushing method of the combined artificial kidney circuit according to claim 1, characterized in that: When pre-flushing is performed in the series pre-flushing mode or in the separate pre-flushing mode, the temperature of the liquid in the arterial line is detected, and if the detected temperature of the liquid in the arterial line is lower than a preset temperature, a temperature alarm signal is issued.

7. The pre-flushing method of the combined artificial kidney circuit according to claim 1, characterized in that: When pre-flushing is performed in the series pre-flushing mode, the liquid temperature in the arterial line and the liquid temperature in the venous line are detected, and the difference between the liquid temperature in the arterial line and the liquid temperature in the venous line is compared with a preset temperature difference. If the difference between the liquid temperature in the arterial line and the liquid temperature in the venous line is greater than the preset temperature difference, the liquid flow in the arterial line is increased.

8. The pre-flushing method of the combined artificial kidney circuit according to claim 1, characterized in that: The pre-rinsing process also includes the mode switching steps: When switching from the single pre-flushing mode to the series pre-flushing mode, increasing the liquid flow rate in the arterial line so that the difference between the liquid flow rate in the arterial line and the preset flow rate value reaches the preset flow rate difference value; When switching from the series pre-flushing mode to the separate pre-flushing mode, the liquid flow in the arterial line is reduced so that the difference between the liquid flow in the arterial line and the preset flow value is less than the preset flow difference.

9. The method for pre-flushing a combined artificial kidney circuit as claimed in claim 8, characterized in that: When switching from the series pre-flushing mode to the separate pre-flushing mode, the blood chamber capacity of the hemoperfusion device and the dialyzer are compared, and if the blood chamber capacity of the hemoperfusion device is greater than the blood chamber capacity of the dialyzer, the pre-flushing liquid is controlled to sequentially pass through the arterial line, the second bypass branch, the hemoperfusion device, the third bypass branch and the fifth bypass branch until the waste liquid bag, so as to pre-flushing the hemoperfusion device; If the blood chamber capacity of the hemoperfusion device is less than or equal to the blood chamber capacity of the dialyzer, the pre-flushing liquid is controlled to pass through the arterial line, the first bypass branch, the fourth bypass branch, the dialyzer and the venous line in sequence until the waste liquid bag, so as to pre-flush the dialyzer.

10. The pre-flushing method of the combined artificial kidney circuit according to claim 1, characterized in that: It also includes a circulatory pre-flushing mode, in which the priming liquid is controlled to circulate in a loop consisting of the first bypass branch, the second bypass branch, the blood perfusion device, and the third bypass branch.

Images