Control device, dialysis system, control method, and program

Abstract

To efficiently suppress deterioration in blood pressure of a patient during artificial dialysis.SOLUTION: A blood pressure decrease detection unit 101 detects that a patient's blood pressure has become a first reference value or less during artificial dialysis of the patient by a dialyzer 200. When the blood pressure decrease detection unit 101 detects that the patient's blood pressure has become a first reference value or less, a control unit 102 causes the dialyzer 200 to temporarily execute water removal restriction processing accompanied by a decrease in a water removal speed or stopping of the water removal in the artificial dialysis, and causes a compression device to execute repetitive compression processing accompanied by repetitive compression to the lower half of the patient's body or repetitive compression to the abdomen of the patient while the patient's lower extremity is raised.SELECTED DRAWING: Figure 6

Description

[Technical field]

[0001] The present disclosure relates to a control device, a dialysis system, a control method, and a program. [Background technology]

[0002] Dialysis is sometimes performed on patients with kidney problems. Dialysis is a technology that removes waste products and fluids from the body in place of damaged kidneys. During dialysis, a water removal process is carried out to remove fluids that have accumulated in the patient's body, and this often causes the patient's blood pressure to drop. If the patient's blood pressure drops too much, dialysis cannot be continued.

[0003] Therefore, currently, technologies are being developed to prevent the patient's blood pressure from dropping too much during dialysis. For example, Patent Document 1 describes a technology in which a compression device compresses the lower half of the patient's body to maintain the patient's blood pressure when the patient's blood pressure suddenly drops during dialysis. [Prior art documents] [Patent documents]

[0004] [Patent Document 1] JP 2006-204760 A Summary of the Invention [Problem to be solved by the invention]

[0005] However, during dialysis, the water removal process may not be effective in sufficiently suppressing the drop in the patient's blood pressure even when the patient's lower body is compressed. Another method for suppressing the drop in the patient's blood pressure may be to compress the patient's abdomen while the patient's lower limbs are elevated. However, even with this method, the water removal process may not be effective in sufficiently suppressing the drop in the patient's blood pressure. For this reason, a technology that can efficiently suppress the drop in the patient's blood pressure during dialysis is desired.

[0006] The present disclosure has been made in consideration of the above-mentioned problems, and aims to provide a control device, dialysis system, control method, and program that efficiently suppress a drop in a patient's blood pressure during artificial dialysis. [Means for solving the problem]

[0007] In order to achieve the above object, a control device according to a first aspect of the present disclosure includes: a blood pressure drop detection means for detecting when the blood pressure of a patient falls below a first reference value during artificial dialysis of the patient by a dialysis device; and a control means for, when the blood pressure drop detection means detects that the patient's blood pressure has fallen below the first reference value, causing the dialysis device to temporarily execute a water removal restriction process which involves a reduction in the water removal rate or a halt in water removal in the artificial dialysis, and causing the compression device to execute a repetitive compression process which involves repetitive compression of the lower body of the patient or repetitive compression of the abdomen of the patient while the patient's lower limbs are being raised.

[0008] The control means may, when the blood pressure drop detection means detects that the patient's blood pressure has fallen below the first reference value, control the dialysis device and the compression device so that a period during which the dialysis device performs the water removal restriction process and a period during which the compression device performs the repetitive compression process overlap.

[0009] When the blood pressure drop detection means detects that the patient's blood pressure has fallen below the first reference value, the control means may cause the dialysis device to start performing the water removal restriction process, and then cause the compression device to start performing the repetitive compression process.

[0010] a blood pressure rise detection means for detecting when the blood pressure of the patient becomes equal to or higher than a second reference value which is higher than the first reference value; The control means may, after causing the dialysis device to start performing the water removal restriction process, cause the dialysis device to terminate execution of the water removal restriction process if the blood pressure increase detection means detects that the patient's blood pressure has reached or exceeded the second reference value.

[0011] In order to achieve the above object, a dialysis system according to a second aspect of the present disclosure includes: A dialysis machine that removes fluids accumulated in the patient's body through artificial dialysis; A compression device that performs a repetitive compression process involving repetitive compression of the patient's lower body or repetitive compression of the patient's abdomen while the patient's lower limbs are being raised; a blood pressure drop detection means for detecting when the blood pressure of the patient falls below a first reference value during artificial dialysis of the patient by the dialysis device; and a control means for, when the blood pressure drop detection means detects that the patient's blood pressure has fallen below the first reference value, causing the dialysis device to temporarily execute a water removal restriction process which involves a reduction in the water removal rate or the cessation of water removal in the artificial dialysis, and causing the compression device to execute the repetitive compression process.

[0012] In order to achieve the above object, a control method according to a third aspect of the present disclosure includes: A control method executed by a control device that controls a dialysis device and a compression device, comprising: When a drop in the patient's blood pressure is detected during artificial dialysis by the dialysis device, the dialysis device is caused to temporarily limit water removal during the artificial dialysis, and the compression device is caused to repeatedly compress the lower body of the patient, or to repeatedly compress the abdomen of the patient while the patient's lower limbs are raised.

[0013] In order to achieve the above object, a program according to a fourth aspect of the present disclosure includes: Computer, a blood pressure drop detection means for detecting when the blood pressure of the patient falls below a first reference value during artificial dialysis of the patient by the dialysis device; When the blood pressure drop detection means detects that the patient's blood pressure has fallen below the first reference value, the control means causes the dialysis device to temporarily execute a water removal restriction process involving a reduction in the water removal rate or the cessation of water removal in the artificial dialysis, and functions as a control means for causing the compression device to execute a repetitive compression process involving repetitive compression of the patient's lower body or repetitive compression of the patient's abdomen while the patient's lower limbs are being raised. Effect of the Invention

[0014] According to the present disclosure, a drop in a patient's blood pressure during artificial dialysis can be efficiently suppressed. [Brief description of the drawings]

[0015] [Figure 1] Configuration diagram of a dialysis system according to the first embodiment [Diagram 2] Configuration diagram of a control device according to the first embodiment [Diagram 3] Configuration diagram of a dialysis device according to embodiment 1 [Figure 4] Configuration diagram of a lower body compression device according to embodiment 1 [Diagram 5] FIG. 1 is an external view of a pressing member according to a first embodiment; [Figure 6] Functional configuration diagram of a control device according to the first embodiment [Figure 7] 1 is a flowchart showing a blood pressure decrease suppression process executed by a control device according to the first embodiment. [Figure 8] Graph showing the accumulated amount of water removed in the dialysis system according to the first embodiment [Figure 9] Graph showing the accumulated amount of water removed in the dialysis system according to Comparative Example 1 [Figure 10] Graph showing the accumulated amount of water removed in the dialysis system according to Comparative Example 2 [Figure 11] Configuration diagram of a dialysis system according to embodiment 2 [Figure 12] FIG. 13 is an external view of a pressing member according to a second embodiment. [Figure 13] Configuration diagram of a lower limb lifting device according to embodiment 2 [Figure 14] FIG. 10 is an explanatory diagram of a leg lifting device according to a second embodiment of the present invention; [Figure 15] Functional configuration diagram of a control device according to the second embodiment [Figure 16] 11 is a flowchart showing a blood pressure decrease suppression process executed by a control device according to a second embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0016] Hereinafter, embodiments of the present disclosure will be described in detail with reference to the drawings. In the drawings, the same or corresponding parts are denoted by the same reference numerals.

[0017] (Embodiment 1) FIG. 1 is a diagram showing the configuration of a dialysis system 1000 according to a first embodiment. The dialysis system 1000 is a system that performs dialysis on a patient 50 who has kidney damage and reduced kidney function. Artificial dialysis refers to the artificial discharge of waste products and water from the body in place of the kidneys. During dialysis, a water removal process is performed to remove water accumulated in the patient's body from the blood flowing through the blood vessels.

[0018] For this reason, the blood pressure of the patient 50 frequently drops during dialysis, and generally the blood pressure of the patient 50 drops over time. If the blood pressure of the patient 50 drops too much, it will have a detrimental effect on the body of the patient 50, and the water removal process must be forcibly stopped. If the water removal process is forcibly stopped, waste products and water will not be sufficiently excreted from the body. Therefore, the dialysis system 1000 has a function of increasing the blood pressure of the patient 50 if the blood pressure of the patient 50 drops during dialysis.

[0019] Methods for increasing the blood pressure of patient 50 mainly include a method of repeatedly compressing the lower body of patient 50 (hereinafter referred to as a "method of compressing the lower body" where appropriate) and a method of repeatedly compressing the abdomen of patient 50 with the lower limbs of patient 50 elevated (hereinafter referred to as a "method of compressing the abdomen with the lower limbs elevated" where appropriate). Compressing the lower body of patient 50 means applying pressure to the entire lower body of patient 50 from around it. The lower body is a concept that includes the abdomen and lower limbs. Compressing the abdomen of patient 50 means applying pressure to the abdomen of patient 50 from around it. Elevating the lower limbs of patient 50 means raising the position of the patient's 50's feet above the position of the patient's 50's heart.

[0020] When the lower body of the patient 50 is repeatedly compressed, blood returns from the venous system of the lower body of the patient 50 to the trunk of the patient 50, and the blood that has returned to the trunk of the patient 50 is supplied to the heart. For this reason, the method of compressing the lower body is expected to have the effect of increasing the blood pressure of the patient 50. Furthermore, when the lower limbs of the patient 50 are raised, blood is more likely to return from the venous system of the lower limbs of the patient 50 to the trunk of the patient 50. In this state, when the abdomen of the patient 50 is repeatedly compressed, the blood that has returned to the trunk of the patient 50 is supplied to the heart. For this reason, the method of compressing the abdomen with the lower limbs raised is expected to have the effect of increasing the blood pressure of the patient 50.

[0021] However, when the water removal rate is high, even if the lower body or abdomen of the patient 50 is compressed, it is difficult to significantly increase the blood pressure of the patient 50. In other words, in order to significantly increase the blood pressure of the patient 50, it is preferable to compress the lower body or abdomen of the patient 50 when the water removal rate is low or when water removal is stopped. Therefore, when the blood pressure of the patient 50 drops during dialysis, the dialysis system 1000 temporarily reduces the water removal rate or temporarily stops water removal, and then repeatedly compresses the lower body of the patient 50. The water removal rate is the amount of water removed per unit time in dialysis.

[0022] 1, the dialysis system 1000 includes a control device 100, a dialysis machine 200, and a lower body compression device 300. The control device 100 is communicatively connected to each of the dialysis machine 200 and the lower body compression device 300.

[0023] The control device 100 is a device that controls the overall operation of the dialysis system 1000. For example, the control device 100 acquires blood pressure information indicating the blood pressure of the patient 50 from the blood pressure sensor 270 provided in the dialysis device 200, and detects a drop in the blood pressure of the patient 50. When the control device 100 detects a drop in the blood pressure of the patient 50, the control device 100 controls the lower body compression device 300 to reduce the water removal speed and controls the lower body compression device 300 to compress the lower body of the patient 50.

[0024] The control device 100 may be a dedicated computer specialized for controlling the dialysis system 1000, or may be a general-purpose computer such as a smartphone, a tablet terminal, a notebook computer, etc. As shown in FIG. 2, the control device 100 includes a control unit 11, a storage unit 12, a display unit 13, an operation reception unit 14, and a communication unit 15.

[0025] The control unit 11 includes a CPU (Central Processing Unit), a ROM (Read Only Memory), a RAM (Random Access Memory), an RTC (Real Time Clock), etc. The CPU is also called a central processing unit, central arithmetic unit, processor, microprocessor, microcomputer, DSP (Digital Signal Processor), etc., and functions as a central arithmetic processing unit that executes processes and calculations related to the control of the control device 100. In the control unit 11, the CPU reads out programs and data stored in the ROM, and uses the RAM as a work area to centrally control the control device 100. The RTC is, for example, an integrated circuit with a clocking function. The CPU can identify the current date and time from the time information read from the RTC.

[0026] The storage unit 12 includes a non-volatile semiconductor memory such as a flash memory, an EPROM (Erasable Programmable ROM), or an EEPROM (Electrically Erasable Programmable ROM), and serves as a so-called auxiliary storage device. The storage unit 12 stores programs and data used by the control unit 11 to execute various processes. The storage unit 12 also stores data generated or acquired by the control unit 11 executing various processes.

[0027] The display unit 13 displays various images according to the control of the control unit 11. The display unit 13 includes a touch screen, a liquid crystal display, etc. The operation reception unit 14 receives various operations from the user and supplies information indicating the contents of the received operations to the control unit 11. The operation reception unit 14 includes a touch screen, a button, a lever, etc.

[0028] The communication unit 15 communicates with various devices according to the control of the control unit 11. The communication unit 15 communicates with various devices in accordance with various wireless communication standards or various wired communication standards. Examples of various wireless communication standards include Wi-Fi (registered trademark), LTE (Long Term Evolution), 4G (4th Generation), 5G (5th Generation), Bluetooth (registered trademark), Zigbee (registered trademark), etc. Examples of various wired communication standards include USB (Universal Serial Bus, registered trademark), Thunderbolt (registered trademark), etc. The communication unit 15 has a communication interface that complies with various communication standards.

[0029] The dialysis device 200 is a device that performs artificial dialysis on the patient 50. As shown in FIG. 3, the dialysis device 200 includes a dialysis control unit 210, a display unit 220, an operation reception unit 230, a communication unit 240, a dialysis fluid supplying device 250, a dialyzer 260, a drainage tank 265, a blood pressure sensor 270, a blood circulation pump 281, and a negative pressure pump 282. The dialysis fluid supplying device 250 and the dialyzer 260 are connected by a pipe 291. The dialyzer 260 and the blood circulation pump 281 are connected by a pipe 292. The blood circulation pump 281 and the radial artery of the patient 50 are connected by a pipe 293. The dialyzer 260 and the forearm cutaneous vein of the patient 50 are connected by a pipe 294. The dialyzer 260 and the negative pressure pump 282 are connected by a pipe 295. The negative pressure pump 282 and the drainage tank 265 are connected by a pipe 296 .

[0030] The dialysis control unit 210 controls the operation of the entire dialysis device 200. The dialysis control unit 210 includes a CPU, a ROM, a RAM, and an RTC. The dialysis control unit 210 starts artificial dialysis according to an instruction to start artificial dialysis from a user. For example, the dialysis control unit 210 controls the blood circulation pump 281 and the negative pressure pump 282 so that the water removal speed of the dialysis device 200 becomes the set water removal speed accepted by the operation acceptance unit 230. The set water removal speed is determined according to, for example, the weight of the patient 50. In addition, the dialysis control unit 210 temporarily reduces the water removal speed according to the control by the control device 100. In addition, the dialysis control unit 210 causes the display unit 220 to display the water removal speed of the dialysis device 200, the set water removal speed, the blood pressure of the patient 50, and the like.

[0031] The display unit 220 displays various images according to the control of the dialysis control unit 210. The dialysis control unit 210 is equipped with a touch screen, a liquid crystal display, etc. The operation reception unit 230 receives various operations from the user and supplies information indicating the contents of the received operations to the dialysis control unit 210. The operation reception unit 230 is equipped with a touch screen, a button, a lever, etc. The communication unit 240 communicates with the control device 100 according to the control of the dialysis control unit 210. The communication unit 240 is equipped with a communication interface that complies with various communication standards.

[0032] The dialysis fluid supplying device 250 prepares the dialysis fluid by mixing the concentrate and water in a predetermined ratio. The dialysis fluid supplying device 250 also adjusts the temperature of the adjusted dialysis fluid to a predetermined temperature. The dialysis fluid supplying device 250 supplies the adjusted dialysis fluid to the dialyzer 260 via the piping 291.

[0033] The dialyzer 260 purifies the blood of the patient 50 using the dialysis fluid supplied from the dialysis fluid supply device 250. Inside the dialyzer 260, waste products and water are transferred from the blood of the patient 50 to the dialysis fluid, and ions necessary for the patient 50 are transferred from the dialysis fluid to the blood. The dialyzer 260 returns the purified blood to the forearm cutaneous vein of the patient 50 via the piping 294. The drain tank 265 stores the dialysis fluid containing the waste products and water supplied from the dialyzer 260.

[0034] The blood pressure sensor 270 detects the blood pressure of the patient 50. The blood pressure sensor 270 is, for example, a blood pressure monitor attached to the arm of the patient 50 to detect the blood pressure of the upper body of the patient 50. The blood pressure sensor 270 supplies blood pressure information indicating the blood pressure of the patient 50 to the control device 100. How the blood pressure of the patient 50 is defined can be adjusted as appropriate. For example, the blood pressure of the patient 50 may be the systolic blood pressure, the diastolic blood pressure, or the mean blood pressure. The mean blood pressure is calculated, for example, by the formula (systolic blood pressure-diastolic blood pressure) / 3+diastolic blood pressure. In this embodiment, the blood pressure of the patient 50 indicates the systolic blood pressure.

[0035] The blood circulation pump 281 supplies blood supplied from the radial artery of the patient 50 via piping 293 to the dialyzer 260 via piping 292. The negative pressure pump 282 introduces the dialysis fluid stored in the dialysis fluid supply device 250 into the dialyzer 260 by creating a negative pressure inside the path from the dialysis fluid supply device 250 to the negative pressure pump 282. The negative pressure pump 282 supplies the dialysis fluid containing waste products and water, supplied from the dialyzer 260 via piping 295, to the drain tank 265 via piping 296.

[0036] The lower body compression device 300 is a device that compresses the lower body of the patient 50. In this embodiment, the lower body compression device 300 compresses the lower body of the patient 50 by adjusting the air pressure inside the compression body 350 attached around the lower body of the patient 50. In this embodiment, the lower body compression device 300 repeats compression of the lower body of the patient 50 and release of the compression of the lower body of the patient 50 at a predetermined cycle. This predetermined cycle is, for example, approximately the same as the respiratory cycle of the patient 50.

[0037] 4, the lower body compression device 300 includes an air pressure control unit 310, a display unit 320, an operation receiving unit 330, a communication unit 340, a compression body 350, a compressor 361, an air tank 362, a pressure reducer 363, an electro-pneumatic regulator 364, an exhaust valve 365, a relief valve 366, an air pressure sensor 367, and a compression pressure sensor 368. Note that a compressed air cylinder may be used instead of the compressor 361 and the air tank 362.

[0038] The air pressure control unit 310 controls the overall operation of the lower body compression device 300. For example, the air pressure control unit 310 controls each unit so that the compression pressure, which is the pressure of the air inside the compression body 350 attached to the lower body of the patient 50, becomes a pressure corresponding to the compression force instructed by the control device 100 via the communication unit 340. The air pressure control unit 310 repeatedly compresses the lower body of the patient 50 and releases the compression of the lower body of the patient 50. In other words, the air pressure control unit 310 increases and decreases the compression pressure at a predetermined cycle to repeatedly compress the lower body of the patient 50.

[0039] In this embodiment, the peak compression pressure when compressing the lower body of the patient 50, that is, the compression pressure when the compression body 350 is most expanded, is simply referred to as the compression pressure as appropriate. Similarly, the peak compression force when compressing the lower body of the patient 50, that is, the compression force when the compression body 350 is most expanded, is simply referred to as the compression force as appropriate. The air pressure control unit 310 includes a CPU, a ROM, a RAM, an RTC, etc.

[0040] The display unit 320 displays various images according to the control of the air pressure control unit 310. The display unit 320 includes a touch screen, a liquid crystal display, etc. The operation reception unit 330 receives various operations from the user and supplies information indicating the contents of the received operations to the air pressure control unit 310. The operation reception unit 330 includes a touch screen, a button, a lever, etc. The communication unit 340 communicates with the control device 100 according to the control of the air pressure control unit 310. The communication unit 340 includes a communication interface that complies with various communication standards.

[0041] The pressing body 350 is a member attached to the lower body of the patient 50 in order to press the lower body of the patient 50. As shown in FIG. 5, the pressing body 350 includes a bag support portion 351, a bag 352A, a bag 352B, a bag 352C, a bag 352D, a bag 352E, an air supply tube 353A, an air supply tube 353B, an air supply tube 353C, an air supply tube 353D, and an air supply tube 353E. Hereinafter, the bag 352A, the bag 352B, the bag 352C, the bag 352D, and the bag 352E are collectively referred to as the bag 352 as appropriate. In addition, the air supply tube 353A, the air supply tube 353B, the air supply tube 353C, the air supply tube 353D, and the air supply tube 353E are collectively referred to as the air supply tube 353 as appropriate.

[0042] The pouch support part 351 is a pants-like member to which the pouch 352 is attached. The pouch 352A is attached to a portion of the pouch support part 351 that corresponds to the abdomen. The pouch 352B is attached to a portion of the pouch support part 351 that corresponds to the thigh of the right leg. The pouch 352C is attached to a portion of the pouch support part 351 that corresponds to the lower leg of the right leg. The pouch 352D is attached to a portion of the pouch support part 351 that corresponds to the thigh of the left leg. The pouch 352E is attached to a portion of the pouch support part 351 that corresponds to the lower leg of the left leg.

[0043] The bag 352 is a member that is inflated by air supplied from the electropneumatic regulator 364 via an air supply tube 353. When the bag 352 is inflated, the lower body of the patient 50 is compressed, and when the bag 352 is contracted, the compression of the lower body of the patient 50 is released. The bag 352 is attached to the bag support part 351 so as to cover at least a part of the area to be compressed. For example, the bag 352A may be attached to the bag support part 351 so as to cover the periphery of the abdomen of the patient 50, or may be attached to the bag support part 351 so as to cover the front or rear side of the abdomen of the patient 50.

[0044] Similarly, the bag 352B may be attached to the bag support part 351 so as to cover the periphery of the right thigh of the patient 50, or may be attached to the bag support part 351 so as to cover the front or rear side of the right thigh of the patient 50. The expansion of the bag 352A compresses the abdomen of the patient 50. The expansion of the bag 352B compresses the right thigh of the patient 50. The expansion of the bag 352C compresses the right lower leg of the patient 50. The expansion of the bag 352D compresses the left thigh of the patient 50. The expansion of the bag 352E compresses the left lower leg of the patient 50. The bag 352A, the bag 352B, the bag 352C, the bag 352D, and the bag 352E basically repeat expansion and contraction at the same timing.

[0045] The air supply tube 353 is a tube for supplying air to the bag body 352 and discharging air from the bag body 352. In other words, the air supply tube 353 is a tube for letting air in and out to adjust the amount of air inside the bag body 352. The air supply tube 353A is a tube for adjusting the amount of air inside the bag body 352A. The air supply tube 353B is a tube for adjusting the amount of air inside the bag body 352B. The air supply tube 353C is a tube for adjusting the amount of air inside the bag body 352C. The air supply tube 353D is a tube for adjusting the amount of air inside the bag body 352D. The air supply tube 353E is a tube for adjusting the amount of air inside the bag body 352E.

[0046] The compressor 361, the air tank 362, the pressure reducer 363, the electropneumatic regulator 364, the exhaust valve 365, and the relief valve 366 constitute an air pressure system that inflates and deflates the compression body 350 attached to the lower body of the patient 50.

[0047] The compressor 361 compresses air and supplies the compressed air (hereinafter referred to as "first compressed air" as appropriate) to an air tank. The air tank 362 stores the first compressed air supplied from the compressor 361. The first compressed air stored in the air tank 362 is supplied to the pressure reducer 363. The pressure reducer 363 reduces the pressure of the first compressed air supplied from the air tank 362 to generate second compressed air. The air pressure of the second compressed air is lower than that of the first compressed air and higher than atmospheric pressure. The air pressure of the second compressed air is at a level that can be handled by the electro-pneumatic regulator 364.

[0048] The electropneumatic regulator 364 supplies the second compressed air supplied from the pressure reducer 363 to the compression body 350. The electropneumatic regulator 364 also extracts the second compressed air from the compression body 350. That is, the electropneumatic regulator 364 adjusts the amount of air inside the compression body 350. The exhaust valve 365 is an electromagnetic valve that opens and closes according to the control of the pneumatic control unit 310. When the exhaust valve 365 opens, the first compressed air inside the pneumatic system is discharged to the outside of the pneumatic system. The relief valve 366 releases the second compressed air when the pressure of the second compressed air supplied from the electropneumatic regulator 364 to the compression body 350 becomes equal to or higher than a threshold value. The relief valve 366 functions as a safety valve that prevents the air pressure of the second compressed air inside the compression body 350 from becoming excessively high.

[0049] The air pressure sensor 367 detects the air pressure of the first compressed air. The air pressure sensor 367 supplies air pressure information indicating the air pressure of the first compressed air to the air pressure control unit 310. The compression pressure sensor 368 detects the air pressure of the second compressed air. The compression pressure sensor 368 supplies compression pressure information indicating the air pressure of the second compressed air to the air pressure control unit 310. The air pressure of the second compressed air is the pressure of the air inside the pressing body 350, and is appropriately referred to as the compression pressure. The air pressure sensor 367 and the compression pressure sensor 368 are, for example, semiconductor air pressure sensors.

[0050] Next, the functions of the control device 100 will be described with reference to Fig. 6. The control device 100 functionally comprises a blood pressure decrease detection unit 101, a control unit 102, and a blood pressure increase detection unit 105. The control unit 102 functionally comprises a dialysis control unit 103 and a compression control unit 104. Each of these functions is realized by software, firmware, or a combination of software and firmware. The software and firmware are written as programs and stored in the ROM or storage unit 12. Then, the CPU executes the programs stored in the ROM or storage unit 12 to realize each of these functions.

[0051] The blood pressure drop detection unit 101 detects that the blood pressure of the patient 50 has fallen below a first reference value during artificial dialysis of the patient 50 by the dialysis device 200. For example, the blood pressure drop detection unit 101 determines whether the blood pressure indicated by the blood pressure information acquired from the blood pressure sensor 270 is below a first reference value. In this embodiment, the blood pressure of the patient 50 is the systolic blood pressure of the patient 50. Therefore, the blood pressure drop detection unit 101 determines whether the systolic blood pressure of the patient 50 has fallen below a first reference value. The value of the first reference value can be appropriately adjusted. For example, the first reference value may be about 60% to 90% of the systolic blood pressure of the patient 50 in a normal state. The blood pressure drop detection unit 101 is an example of a blood pressure drop detection means.

[0052] The control unit 102 controls the dialysis machine 200 and the lower body compression device 300. The dialysis control unit 103 included in the control unit 102 controls the dialysis machine 200. The compression control unit 104 included in the control unit 102 controls the lower body compression device 300. When the blood pressure drop detection unit 101 detects that the blood pressure of the patient 50 has fallen below the first reference value, the dialysis control unit 103 causes the dialysis machine 200 to temporarily execute a water removal restriction process. The water removal restriction process is a process that restricts water removal by artificial dialysis, and is a process that involves a reduction in the water removal speed or a stop of water removal. The water removal restriction process may be a process that maintains a state in which the water removal speed is reduced, or a process that maintains a state in which water removal is stopped. In this embodiment, the water removal restriction process is a process that maintains a state in which the water removal speed is reduced.

[0053] The dialysis control unit 103 transmits, for example, a command to the dialysis device 200 to instruct the dialysis device 200 to decrease the water removal speed. The dialysis device 200 that receives this command decreases the water removal speed. For example, the dialysis control unit 210 included in the dialysis device 200 controls the blood circulation pump 281 and the negative pressure pump 282 to decrease the water removal speed. The dialysis control unit 103 may maintain the water removal speed at a constant value during the water removal control process, or may change the water removal speed. For example, the dialysis control unit 103 may change the water removal speed according to the blood pressure of the patient 50 during the water removal control process. Specifically, the dialysis control unit 103 may decrease the water removal speed as the blood pressure of the patient 50 decreases, thereby promoting an increase in the blood pressure of the patient 50.

[0054] When the blood pressure drop detection unit 101 detects that the blood pressure of the patient 50 has fallen below a first reference value, the compression control unit 104 causes the lower body compression device 300 to execute a repetitive compression process. The repetitive compression process is a process of repeatedly applying compression to the patient 50. The repetitive compression process may be a process of repeatedly applying compression to the lower body of the patient 50, or a process of repeatedly applying compression to the abdomen of the patient 50 while the lower limbs of the patient 50 are being raised. In this embodiment, the repetitive compression process is a process of repeatedly applying compression to the lower body of the patient 50.

[0055] The compression control unit 104 transmits, for example, a command to the lower body compression device 300 to instruct repeated compression of the lower body of the patient 50. The lower body compression device 300 that receives this command repeats repeated compression of the lower body of the patient 50. For example, the pneumatic control unit 310 included in the lower body compression device 300 controls the electro-pneumatic regulator 354 to repeatedly expand and contract the compression body 350, thereby repeatedly compressing the lower body of the patient 50.

[0056] The compression control unit 104 may maintain the compression pressure at a constant value during the execution of the repetitive compression process, or may change the compression pressure. For example, the compression control unit 104 may change the compression pressure according to the blood pressure of the patient 50 during the execution of the repetitive compression process. Specifically, the compression control unit 104 may increase the compression pressure as the blood pressure of the patient 50 decreases, thereby promoting an increase in the blood pressure of the patient 50. As described above, the compression pressure is the peak compression pressure when the compression body 350 is most expanded. The control unit 102 is an example of a control means. The dialysis device 200 is an example of a dialysis device. The lower body compression device 300 is an example of a compression device.

[0057] When the blood pressure drop detection unit 101 detects that the blood pressure of the patient 50 has fallen below the first reference value, the control unit 102 controls the dialysis device 200 and the lower body compression device 300 so that the period during which the dialysis device 200 performs the water removal restriction process and the period during which the lower body compression device 300 performs the repetitive compression process overlap. The order in which the water removal restriction process and the repetitive compression process are performed can be adjusted as appropriate. For example, the water removal restriction process may be started before the repetitive compression process is started. Also, the water removal restriction process may be started after the repetitive compression process is started. Also, the water removal restriction process and the repetitive compression process may be started simultaneously.

[0058] In this embodiment, the control unit 102 causes the dialysis machine 200 to start executing the water removal restriction process, and then causes the lower body compression device 300 to start executing the repetitive compression process. For example, when the blood pressure drop detection unit 101 detects that the blood pressure of the patient 50 has fallen below a first reference value, the dialysis control unit 103 transmits a command to the dialysis machine 200 to instruct it to start the water removal restriction process. On the other hand, the compression control unit 104 transmits a command to the lower body compression device 300 to instruct it to start the repetitive compression process after the water removal restriction process of the dialysis machine 200 starts and before it ends.

[0059] In this embodiment, since water removal is basically continued during dialysis, when the repetitive compression process is terminated during dialysis, the blood pressure of the patient 50 drops. On the other hand, when dialysis is terminated, the blood in the dialysis device 200 is returned to the patient 50, so the blood pressure of the patient 50 rises. Therefore, in this embodiment, if the repetitive compression process is started during dialysis, the lower body compression device 300 ends the repetitive compression process at the end of dialysis. With this configuration, the rise in the blood pressure of the patient 50 accompanying the end of dialysis and the drop in the blood pressure of the patient 50 accompanying the end of the repetitive compression process are offset, and the drop in the blood pressure of the patient 50 due to the end of the repetitive compression process is suppressed.

[0060] The blood pressure rise detection unit 105 detects that the patient's blood pressure has reached or exceeded a second reference value that is higher than the first reference value. For example, the blood pressure rise detection unit 105 determines whether the blood pressure indicated by the blood pressure information acquired from the blood pressure sensor 270 is equal to or higher than the second reference value. The value of the second reference value can be adjusted as appropriate. For example, the second reference value may be set to about 110% to 150% of the first reference value. The blood pressure rise detection unit 105 is an example of a blood pressure rise detection means.

[0061] Next, the blood pressure drop suppression process executed by the control device 100 will be described with reference to the flowchart of Fig. 7. The blood pressure drop suppression process is executed in response to, for example, the start of artificial dialysis by the dialysis device 200. The blood pressure drop suppression process is terminated in response to, for example, the end of artificial dialysis by the dialysis device 200.

[0062] First, the control unit 11 included in the control device 100 acquires blood pressure information (step S101). For example, the control unit 11 acquires the blood pressure information from the blood pressure sensor 270 via the communication unit 15. After completing the process of step S101, the control unit 11 determines whether the blood pressure of the patient 50 is equal to or lower than a first reference value (step S102). For example, the control unit 11 determines whether the blood pressure indicated by the acquired blood pressure information is equal to or lower than the first reference value. The information indicating the first reference value is stored in the storage unit 12, for example.

[0063] When the control unit 11 determines that the blood pressure of the patient 50 is not equal to or lower than the first reference value (step S102: NO), the control unit 11 returns the process to step S101. When the control unit 11 determines that the blood pressure of the patient 50 is equal to or lower than the first reference value (step S102: YES), the control unit 11 instructs the dialysis device 200 to start the water removal restriction process (step S103). For example, the control unit 11 transmits a command to the dialysis device 200 via the communication unit 15 to instruct the dialysis device 200 to start the water removal restriction process. When the dialysis device 200 receives this command, it starts the water removal restriction process. That is, the dialysis device 200 reduces the water removal speed and continues the dialysis process.

[0064] When the control unit 11 completes the process of step S103, the control unit 11 waits for a specified time (step S104). This specified time is, for example, about several minutes. Information indicating this specified time is stored in the storage unit 12, for example.

[0065] When the control unit 11 completes the process of step S104, it instructs the lower body compression device 300 to start the repetitive compression process (step S105). For example, the control unit 11 transmits a command instructing the start of the repetitive compression process to the lower body compression device 300 via the communication unit 15. When the lower body compression device 300 receives this command, it starts the repetitive compression process. That is, the lower body compression device 300 starts the process of repeatedly expanding and contracting the compression body 350, and starts the process of repeatedly compressing the lower body of the patient 50.

[0066] Upon completing the process of step S105, the control unit 11 acquires blood pressure information (step S106). Upon completing the process of step S106, the control unit 11 determines whether the blood pressure of the patient 50 is equal to or higher than the second reference value (step S107). For example, the control unit 11 determines whether the blood pressure indicated by the acquired blood pressure information is equal to or higher than the second reference value. The information indicating the second reference value is stored in the storage unit 12, for example.

[0067] When the control unit 11 determines that the blood pressure of the patient 50 is not equal to or higher than the second reference value (step S107: NO), the control unit 11 returns the process to step S106. When the control unit 11 determines that the blood pressure of the patient 50 is equal to or higher than the second reference value (step S107: YES), the control unit 11 instructs the dialysis device 200 to end the water removal restriction process (step S108).

[0068] For example, the control unit 11 transmits a command to the dialysis device 200 via the communication unit 15 to instruct the end of the water removal restriction process. When the dialysis device 200 receives this command, it ends the water removal restriction process. That is, the dialysis device 200 returns the water removal speed to the set water removal speed and continues the dialysis process. When the control unit 11 completes the process of step S108, it returns the process to step S101.

[0069] Next, referring to Fig. 8, the cumulative amount of water removed in the dialysis system 1000 according to this embodiment will be described. The cumulative amount of water removed is the cumulative value of the amount of water removed from the start of artificial dialysis to the current time. Fig. 8 shows the time changes of the systolic blood pressure, pants pressure, water removal speed, and cumulative amount of water removed when the dialysis system 1000 performs dialysis for four hours. The pants pressure is the compression pressure applied by the compression body 350. The dashed line L10 is the target cumulative amount of water removed. The solid line L11 is the actual cumulative amount of water removed in the dialysis system 1000.

[0070] t11 is the time when the systolic blood pressure falls to the first reference value, and is the time when the water removal restriction process is started. t12 is the time when the repetitive compression process is started. t13 is the time when the systolic blood pressure rises to the second reference value, and is the time when the water removal restriction process is ended. Until t11, the systolic blood pressure was maintained at or above the first reference value. Therefore, until t11, the repetitive compression process was not performed, and the pants pressure was 0. Furthermore, until t11, the water removal restriction process was not performed, and the water removal speed was maintained at the set water removal speed. Therefore, until t11, the accumulated water removal volume increased in proportion to time.

[0071] At t11, the systolic blood pressure became equal to or lower than the first reference value, and the water removal restriction process was started. Therefore, after t11, the water removal speed became lower than the set water removal speed, the increase in the cumulative water removal volume decreased, and the decrease in systolic blood pressure was suppressed to some extent. At t12, the repetitive compression process was started. In other words, after t12, the water removal restriction process and the repetitive compression process were performed in parallel. Therefore, after t12, the systolic blood pressure rose rapidly.

[0072] At t13, the systolic blood pressure exceeded the second reference value, and the water removal restriction process ended. Therefore, after t13, the water removal speed returned to the set water removal speed, and the cumulative water removal volume increased. Since the repeated compression process was maintained even after t13, the decrease in systolic blood pressure was suppressed to some extent. Four hours after the start of dialysis, dialysis ended.

[0073] In the dialysis system 1000, when the systolic blood pressure falls below the first reference value, the water removal speed is lowered to a certain extent by the water removal restriction process, and then the lower body of the patient 50 is repeatedly compressed by the repetitive compression process. When the lower body of the patient 50 is repeatedly compressed when the water removal speed is low, the systolic blood pressure increases rapidly. In addition, in the dialysis system 1000, the repetitive compression process is performed even after the water removal speed is restored and the water removal restriction process is completed. Therefore, in the dialysis system 1000, the decrease in the systolic blood pressure is suppressed to a certain extent even after the water removal speed is returned to the set water removal speed. As a result, in the dialysis system 1000, the accumulated water removal volume was able to be maintained at 95% of the target accumulated water removal volume at the end of artificial dialysis.

[0074] Next, referring to FIG. 9, the cumulative amount of water removed in the dialysis system according to Comparative Example 1 will be described. FIG. 9 shows the time changes of the systolic blood pressure, pants pressure, water removal speed, and cumulative amount of water removed when the dialysis system according to Comparative Example 1 performs dialysis for 4 hours. The solid line L12 is the actual cumulative amount of water removed in the dialysis system according to Comparative Example 1. The dialysis system according to Comparative Example 1 is a system in which neither the water removal restriction process nor the repeated compression process is performed. However, in the dialysis system according to Comparative Example 1, when the systolic blood pressure falls to a third reference value lower than the first reference value, a forced water removal restriction process is performed in which the water removal speed is forcibly reduced in consideration of the safety of the patient 50. In the dialysis system 1000, the systolic blood pressure did not fall to the third reference value, so the forced water removal restriction process was not performed.

[0075] t21 is the time when the systolic blood pressure has fallen to the third reference value and the forced water removal restriction process has started. t22 is the time when the systolic blood pressure has fallen to a fourth reference value lower than the third reference value and the water removal speed has been further reduced in the forced water removal restriction process. t23 is the time when the systolic blood pressure has recovered and the water removal speed has been increased to a certain degree in the forced water removal restriction process.

[0076] In the dialysis system according to Comparative Example 1, neither the water removal restriction process nor the repetitive compression process is performed. Therefore, until t21, the repetitive compression process and the water removal restriction process are not performed, the pants pressure is 0, and the accumulated water removal volume increases in proportion to time. At t21, the systolic blood pressure becomes equal to or lower than the third reference value, and the forced water removal restriction process is started. Therefore, after t21, the water removal speed becomes lower than the set water removal speed, and the increase in the accumulated water removal volume decreases. Furthermore, after t21, the repetitive compression process is not performed, and the decrease in systolic blood pressure continues.

[0077] At t22, the systolic blood pressure falls below the fourth reference value, and the water removal rate further decreases during the forced water removal restriction process. Therefore, after t22, the increase in the cumulative water removal volume drops sharply. However, since the repeated compression process is not performed after t22, the systolic blood pressure does not increase significantly. At t23, the systolic blood pressure recovers to a certain extent, and the water removal rate is increased to a certain extent by the forced water removal restriction process. Therefore, after t23, the increase in the cumulative water removal volume increases to a certain extent. After four hours have passed since the start of dialysis, dialysis ends.

[0078] In the dialysis system according to Comparative Example 1, neither the water removal restriction process nor the repeated compression process is performed, and when the systolic blood pressure falls below the third reference value, the forced water removal restriction process is performed. During the period in which the forced water removal restriction process is performed, the water removal speed is low, and the increase in the accumulated water removal volume is small. In addition, in the dialysis system according to Comparative Example 1, the process for suppressing the drop in the systolic blood pressure is not performed until the systolic blood pressure falls below the third reference value, and the repeated compression process is not performed even after the systolic blood pressure falls below the third reference value. For this reason, the drop in the systolic blood pressure is severe, and the recovery of the systolic blood pressure is slow, so that the period in which the forced water removal restriction process is performed is prolonged. As a result, in the dialysis system according to Comparative Example 1, the accumulated water removal volume at the end of artificial dialysis was 83% of the target accumulated water removal volume.

[0079] Next, referring to FIG. 10, the cumulative amount of water removed in the dialysis system according to Comparative Example 2 will be described. FIG. 10 shows the time changes of the systolic blood pressure, pants pressure, water removal speed, and cumulative amount of water removed when the dialysis system according to Comparative Example 2 performs dialysis for 4 hours. The solid line L13 is the actual cumulative amount of water removed in the dialysis system according to Comparative Example 2. The dialysis system according to Comparative Example 2 is a system in which, when the systolic blood pressure falls below the first reference value, a repeated compression process is performed, and a water removal restriction process is not performed. In the dialysis system according to Comparative Example 2, when the systolic blood pressure falls to a third reference value lower than the first reference value, a forced water removal restriction process is performed in which the water removal speed is forcibly reduced.

[0080] t31 is the time when the systolic blood pressure falls to the first reference value and the repetitive compression process is started. t32 is the time when the systolic blood pressure falls to the third reference value and the forced water removal restriction process is started. t33 is the time when the systolic blood pressure recovers and the water removal speed is increased to a certain extent in the forced water removal restriction process.

[0081] In the dialysis system according to Comparative Example 2, neither the water removal restriction process nor the repetitive compression process is performed until t31. Therefore, until t31, the pants pressure is 0, and the accumulated water removal volume increases in proportion to time. At t31, the systolic blood pressure falls below the first reference value, and the repetitive compression process is started, but the water removal restriction process is not performed. Therefore, the decrease in the systolic blood pressure continues even after t31.

[0082] At t32, the systolic blood pressure falls below the third reference value, and forced water removal restriction processing is initiated. Therefore, after t32, the water removal speed becomes lower than the set water removal speed, and the increase in the accumulated water removal volume decreases. On the other hand, after t32, the systolic blood pressure rises. At t33, the systolic blood pressure recovers to a certain extent, and the water removal speed is raised to a certain extent in the forced water removal restriction processing. Therefore, after t33, the increase in the accumulated water removal volume increases to a certain extent. After four hours have passed since the start of dialysis, dialysis ends.

[0083] In the dialysis system according to Comparative Example 2, when the systolic blood pressure falls below the first reference value, the repeated compression process is performed, but the water removal restriction process is not performed. Even if the repeated compression process is performed in a state in which the water removal restriction process is not performed, the drop in the systolic blood pressure is not sufficiently suppressed. In addition, in the dialysis system according to Comparative Example 2, when the systolic blood pressure falls below the third reference value, the forced water removal restriction process is performed. During the period in which the forced water removal restriction process is performed, the water removal speed is low and the increase in the accumulated water removal volume is small. In the dialysis system according to Comparative Example 2, the recovery of the systolic blood pressure is slow, and the forced water removal restriction process is performed. As a result, in the dialysis system according to Comparative Example 2, at the end of artificial dialysis, the accumulated water removal volume was 89% of the target accumulated water removal volume.

[0084] Thus, in the dialysis system 1000 according to the present embodiment, the systolic blood pressure recovered faster than in the dialysis systems according to Comparative Example 1 and Comparative Example 2, and therefore the accumulated amount of water removed at the end of artificial dialysis was larger. The reason for this is that in the dialysis system 1000, the water removal speed temporarily drops earlier, but the water removal restriction process and the repeated compression process are executed in parallel to achieve an efficient increase in blood pressure, so the forced water removal restriction process is not executed, and as a result, the accumulated amount of water removed is larger.

[0085] In this embodiment, when it is detected that the blood pressure of the patient 50 has fallen below the first reference value, the water removal restriction process is temporarily executed, and the repetitive compression process is executed. Here, blood pressure control in the human body is performed in a closed system in which blood is in the blood vessels. In artificial dialysis, water is forcibly discharged from this closed system to the outside in a short time. Since the amount of blood in the blood vessels is rapidly reduced by the discharge of water, artificial dialysis cannot maintain blood pressure, and blood pressure drops. Therefore, when the water removal restriction process is executed and the water removal speed is reduced or the water removal is stopped, this condition is alleviated and the drop in blood pressure is suppressed. In addition, when the repetitive compression process is executed, venous blood in the lower body, including the abdomen, is returned to the heart. Therefore, the amount of blood ejected from the heart increases, and blood pressure rises. A high blood pressure rise effect can be expected due to the effect of suppressing the drop in blood pressure by the water removal restriction process and the effect of increasing blood pressure by the repetitive compression process. Therefore, according to this embodiment, the drop in blood pressure of the patient 50 during artificial dialysis can be efficiently suppressed.

[0086] In addition, in this embodiment, the period during which the water removal restriction process is performed overlaps with the period during which the repetitive compression process is performed. Therefore, in this embodiment, the water removal restriction process and the repetitive compression process cause the blood pressure of the patient 50 to rise significantly. Therefore, according to this embodiment, the drop in blood pressure of the patient 50 during artificial dialysis can be more efficiently suppressed.

[0087] In this embodiment, the execution of the water removal restriction process is started, and then the execution of the repetitive compression process is started. Here, when blood pressure drops during artificial dialysis, the water removal restriction process can be performed relatively quickly. However, the appearance of the blood pressure effect by the water removal restriction process is generally slower than that of the repetitive compression process. For example, in the water removal restriction process, it takes several minutes (e.g., 3 to 5 minutes) for the blood pressure effect to occur, but in the repetitive compression process, it takes about 1 minute for the blood pressure effect to occur. In this embodiment, the water removal restriction process is started first, and the blood pressure is in a state where it is difficult to drop and easy to rise. After that, when the repetitive compression process is started in a state where the blood pressure is easy to rise, a quick recovery of the blood pressure can be expected. Therefore, according to this embodiment, the drop in the blood pressure of the patient 50 during artificial dialysis can be more efficiently suppressed.

[0088] In this embodiment, after the execution of the water removal restriction process is started, when the blood pressure of the patient 50 becomes equal to or higher than the second reference value, the execution of the water removal restriction process is terminated. Therefore, according to this embodiment, it is possible to suppress a decrease in the blood pressure of the patient 50 during artificial dialysis while suppressing a decrease in the amount of water removed.

[0089] (Embodiment 2) In the first embodiment, an example is described in which the repetitive compression process is performed by repeatedly compressing the lower body of the patient 50. In the present embodiment, an example is described in which the repetitive compression process is performed by repeatedly compressing the abdomen of the patient 50 while the patient 50 is lifting its lower limbs. Note that the description of the same configurations and functions as those in the first embodiment will be omitted or simplified as appropriate.

[0090] As shown in Fig. 11, the dialysis system 1000A includes a control device 100A, a dialysis machine 200, an abdominal compression device 300A, and a lower limb lifting device 400. The control device 100A is communicatively connected to each of the dialysis machine 200, the abdominal compression device 300A, and the lower limb lifting device 400. The control device 100A is basically configured similarly to the control device 100.

[0091] The abdominal compression device 300A is a device that compresses the abdomen of the patient 50. In this embodiment, the abdominal compression device 300A compresses the abdomen of the patient 50 by adjusting the air pressure inside the compression body 350A attached around the abdomen of the patient 50. In this embodiment, the abdominal compression device 300A repeats compression of the abdomen of the patient 50 and release of the compression of the abdomen of the patient 50 at a predetermined cycle. This predetermined cycle is, for example, approximately the same as the respiratory cycle of the patient 50. The abdominal compression device 300A basically has the same configuration as the compression body 350, except that the abdominal compression device 300A is provided with the compression body 350A instead of the compression body 350.

[0092] The pressing body 350A is a belt-shaped member that is attached to the abdomen of the patient 50 to pressurize the abdomen of the patient 50. As shown in Fig. 12, the pressing body 350A includes an inflatable portion 351A, an attachment portion 351B, an attachment portion 351C, and an air supply tube 353F. The pressing body 350A is formed by connecting the inflatable portion 351A, the attachment portion 351B, and the attachment portion 351C.

[0093] The expansion section 351A is a portion that expands to compress the abdomen of the patient 50. A bag body 352F is provided inside the expansion section 351A. An air supply tube 353F is connected to the bag body 352F. The bag body 352F is inflated with air supplied from the electropneumatic regulator 364 via the air supply tube 353F, and expands the expansion section 351A. The expansion of the expansion section 351A compresses the abdomen of the patient 50. Furthermore, when air is released via the air supply tube 353F, the bag body 352F contracts, and contracts the expansion section 351A. When the expansion section 351A contracts, the compression of the abdomen of the patient 50 is released.

[0094] The attachment portion 351B and the attachment portion 351C are portions for attaching the inflatable portion 351A to the abdomen of the patient 50. The attachment portion 351B is provided at one end of the inflatable portion 351A, and the attachment portion 351C is provided at the other end of the inflatable portion 351A. The attachment portion 351B and the attachment portion 351C are provided with hook-and-loop fasteners. The air supply tube 353F is a tube for supplying air to the bag body 352F and releasing air from the bag body 352F.

[0095] The pressing body 350A is wrapped around the abdomen of the patient 50, that is, the lower part of the torso of the patient 50. When the pressing body 350A is wrapped around the abdomen of the patient 50, the attachment parts 351B and 351C are fitted around the back of the patient 50. The hook-and-loop fastener of the attachment part 351B and the hook-and-loop fastener of the attachment part 351C are engaged with each other, so that the pressing body 350A is fixed to the abdomen of the patient 50. When the pressing body 350A is fixed to the abdomen of the patient 50, the inflatable part 351A is disposed on the abdomen of the patient 50.

[0096] The lower limb lifting device 400 is a device that executes a lower limb lifting process that is a process of lifting the lower limbs of the patient 50. In this embodiment, the lower limb lifting device 400 lifts a part of the placement table 450 on which the lower limbs of the patient 50 are placed from the floor, thereby lifting the lower limbs of the patient 50. The lifting height, which is the height to which the lower limbs of the patient 50 are lifted, may be determined in advance or may be specified by the control device 100. For example, the control device 100 may determine the lifting height depending on the degree of decrease in blood pressure of the patient 50. For example, the control device 100 may increase the lifting height as the degree of decrease in blood pressure of the patient 50 increases. As shown in FIG. 13, the lower limb lifting device 400 includes a drive control unit 410, a display unit 420, an operation reception unit 430, a communication unit 440, a placement table 450, a drive circuit 460, a motor 470, and an encoder 480.

[0097] The drive control unit 410 controls the overall operation of the lower limb lifting device 400. For example, when the drive control unit 410 receives a lifting instruction from the control device 100 via the communication unit 440, the drive control unit 410 controls the drive circuit 460 that drives the motor 470 to lift a part of the placement table 450 from the floor and lift the lower limbs of the patient 50. The drive control unit 410 includes a CPU, a ROM, a RAM, an RTC, and the like.

[0098] The display unit 420 displays various images according to the control of the drive control unit 410. The display unit 420 includes a touch screen, a liquid crystal display, etc. The operation reception unit 430 receives various operations from a user and supplies information indicating the contents of the received operations to the drive control unit 410. The operation reception unit 430 includes a touch screen, a button, a lever, etc. The communication unit 440 communicates with the control device 100A according to the control of the drive control unit 410. The communication unit 440 includes a communication interface that complies with various communication standards.

[0099] The placement table 450 is a table on which the lower limbs of the patient 50 are placed. As shown in Fig. 14, the placement table 450 includes a fixed part 451, an inclined part 452, a lifting part 453, a rotating shaft 454, and a rotating shaft 455. The fixed part 451, the inclined part 452, and the lifting part 453 are plate-like members. The placement table 450 is generally plate-like when the lifting part 453 is not lifted up from the floor. The state of the placement table 450 changes when the motor 470 is driven.

[0100] The fixed part 451 is a member fixed to a floor. The state of the fixed part 451 does not change by driving the motor 470. In other words, the fixed part 451 remains placed on the floor even when the motor 470 is driven. The buttocks of the patient 50 are placed on the fixed part 451.

[0101] The inclined portion 452 is a member that inclines with respect to the floor surface. The inclined portion 452 rotates with respect to the fixed portion 451 about a rotation axis 454 by driving the motor 470. The inclined portion 452 changes an inclination angle θ1, which is an inclination with respect to the floor surface, by driving the motor 470. The thighs of the patient 50 are placed on the inclined portion 452.

[0102] The lifting / lowering unit 453 is a member that rises or falls when driven by the motor 470. The lifting / lowering unit 453 rotates around a rotation shaft 455 relative to the inclined unit 452 when driven by the motor 470. The lifting / lowering unit 453 rises or falls while maintaining a state parallel to the floor surface. The lower leg of the patient 50 is placed on the lifting / lowering unit 453. Note that in FIG. 14, illustration of a mechanism for rotating or moving the inclined unit 452 and the lifting / lowering unit 453 when driven by the motor 470 is omitted.

[0103] The driving circuit 460 is a circuit that drives the motor 470 according to the control by the driving control unit 410. For example, the driving circuit 460 outputs a pulse signal to the motor 470 according to a driving instruction by the driving control unit 410. The driving circuit 460 includes a driver IC (Integrated Circuit) for driving the motor 470. The driving circuit 460 drives the motor 470 until the above-mentioned θ1 becomes a predetermined angle and the lifting height h1, which is the length from the floor surface to the lifting unit 453, becomes a predetermined height.

[0104] The motor 470 is a device that converts electrical energy into mechanical energy. The motor 470 rotates in a forward or reverse direction according to a pulse signal supplied from the drive circuit 460. In addition, a part of the placement table 450 rotates or moves with the rotation of the motor 470. Specifically, with the rotation of the motor 470, the inclination of the inclined portion 452 changes, and the lifting portion 453 rises or falls. When the motor 470 rotates in the forward direction, the inclination of the inclined portion 452 becomes large, and the lifting portion 453 rises. When the motor 470 rotates in the reverse direction, the inclination of the inclined portion 452 becomes small, and the lifting portion 453 falls. The motor 470 is, for example, a stepping motor.

[0105] The encoder 480 is a sensor that detects a change in mechanical position and outputs an electrical signal indicating the detection result. In this embodiment, the encoder 480 detects an angle that changes with the driving of the motor 470 and supplies an electrical signal indicating the detected angle to the drive control unit 410. The encoder 480 may detect the rotation angle of the motor 470, or may detect θ1, which is the inclination angle of the inclined portion 452 with respect to the floor surface. The encoder 480 is, for example, a rotary encoder.

[0106] Next, the function of the control device 100A will be described with reference to Fig. 15. The control device 100A functionally includes a blood pressure decrease detection unit 101, a control unit 102A, and a blood pressure increase detection unit 105. The control unit 102A functionally includes a dialysis control unit 103, a compression control unit 104A, and an elevation control unit 106. The control device 100A has a similar configuration to the control device 100, except that it includes the control unit 102A instead of the control unit 102. The control unit 102A has a similar configuration to the control unit 102, except that it includes the compression control unit 104A instead of the compression control unit 104, and the elevation control unit 106.

[0107] The compression control unit 104A controls the abdominal compression device 300A. When the blood pressure drop detection unit 101 detects that the blood pressure of the patient 50 has fallen below a first reference value, the compression control unit 104A causes the abdominal compression device 300A to execute a repetitive compression process. In this embodiment, the repetitive compression process is a process of repeatedly compressing the abdomen of the patient 50 while the lower limbs of the patient 50 are being raised. The method of controlling the abdominal compression device 300A by the compression control unit 104A is basically the same as the method of controlling the lower body compression device 300 by the compression control unit 104.

[0108] The lift control unit 106 controls the lower limb lifting device 400. Specifically, when the blood pressure drop detection unit 101 detects that the blood pressure of the patient 50 has fallen to or below a first reference value, the lift control unit 106 controls the lower limb lifting device 400 so that the lower limbs of the patient 50 are lifted while the abdominal compression device 300A is performing the repeated compression process.

[0109] For example, before the abdominal compression device 300A starts a repetitive compression process, the lift control unit 106 transmits a command to the lower limb lifting device 400 to instruct the patient 50 to lift the lower limbs. Upon receiving this command, the lower limb lifting device 400 rotates the motor 470 in the forward direction to raise the lifting unit 453. In addition, after the abdominal compression device 300A ends the repetitive compression process, the lift control unit 106 transmits a command to the lower limb lifting device 400 to instruct the patient 50 to release the lifting of the lower limbs. Upon receiving this command, the lower limb lifting device 400 rotates the motor 470 in the reverse direction to lower the lifting unit 453.

[0110] Next, the blood pressure decrease suppression process executed by the control device 100A will be described with reference to the flowchart of Fig. 16. The blood pressure decrease suppression process executed by the control device 100A is basically the same as the blood pressure decrease suppression process executed by the control device 100, except that the process of step S105A and the process of step S105B are executed instead of the process of step S105.

[0111] When the process of step S104 is completed, the control unit 11 included in the control device 100A instructs the lower limb lifting device 400 to lift the lower limb (step S105A). For example, the control unit 11 transmits a command to instruct the lower limb lifting device 400 to lift the lower limb via the communication unit 15 included in the control device 100A. Upon receiving this command, the lower limb lifting device 400 lifts the lower limb of the patient 50.

[0112] When the control unit 11 completes the process of step S105A, it instructs the abdominal compression device 300A to start the repetitive compression process (step S105B). For example, the control unit 11 transmits a command to instruct the abdominal compression device 300A to start the repetitive compression process via the communication unit 15. When the abdominal compression device 300A receives this command, it starts the repetitive compression process. That is, the abdominal compression device 300A starts the process of repeatedly expanding and contracting the compression body 350A, and starts the process of repeatedly compressing the abdomen of the patient 50 with the lower limbs of the patient 50 raised. When the control unit 11 completes the process of step S105B, it executes the processes of step S106 and onward.

[0113] In this embodiment, similarly to the first embodiment, when it is detected that the blood pressure of the patient 50 has fallen below the first reference value, the water removal restriction process is temporarily executed and the repeated compression process is executed. Therefore, the same effect as that of the first embodiment can be obtained in this embodiment. In other words, according to this embodiment, the drop in the blood pressure of the patient 50 during artificial dialysis can be efficiently suppressed.

[0114] (Modification) Although the embodiments have been described above, various modifications and applications are possible. It is up to the discretion of which parts of the configurations, functions, and operations described in the above embodiments are adopted. In addition to the above-mentioned configurations, functions, and operations, further configurations, functions, and operations may be adopted. The configurations, functions, and operations described in the above embodiments can be freely combined.

[0115] In the first embodiment, an example was described in which the dialysis system 1000 includes the control device 100, the dialysis device 200, and the lower body compression device 300, and the control device 100 causes the dialysis device 200 to execute the water removal restriction process, and the control device 100 causes the lower body compression device 300 to execute the repetitive compression process. Any configuration may be used as long as the water removal restriction process and the repetitive compression process can be appropriately performed.

[0116] For example, the dialysis machine 200 may have the function of the control device 100, the dialysis machine 200 may execute the water removal restriction process, and the dialysis machine 200 may cause the lower body compression device 300 to execute the repetitive compression process. Alternatively, the lower body compression device 300 may have the function of the control device 100, the lower body compression device 300 may cause the dialysis machine 200 to execute the water removal restriction process, and the lower body compression device 300 may execute the repetitive compression process. Alternatively, the dialysis machine 200 may have the function of the lower body compression device 300, and the dialysis machine 200 may execute the water removal restriction process and the repetitive compression process.

[0117] In the second embodiment, the dialysis system 1000A includes the control device 100A, the dialysis device 200, the abdominal compression device 300A, and the lower limb lifting device 400, and the control device 100A causes the dialysis device 200 to execute the water removal restriction process, the control device 100A causes the abdominal compression device 300A to execute the repetitive compression process, and the control device 100A causes the lower limb lifting device 400 to execute the lower limb lifting process. Any configuration may be used as long as the water removal restriction process, the repetitive compression process, and the lower limb lifting process can be appropriately performed. For example, the dialysis device 200 may have the function of the control device 100A, the dialysis device 200 may execute the water removal restriction process, the dialysis device 200 may cause the abdominal compression device 300A to execute the repetitive compression process, and the dialysis device 200 may cause the lower limb lifting device 400 to execute the lower limb lifting process.

[0118] Alternatively, the abdominal compression device 300A may have the function of the control device 100A, the abdominal compression device 300A may cause the dialysis device 200 to perform the water removal restriction process, the abdominal compression device 300A may perform the repetitive compression process, and the lower limb lifting device 400 may perform the lower limb lifting process. Alternatively, the lower limb lifting device 400 may have the function of the control device 100A, the abdominal compression device 300A may cause the dialysis device 200 to perform the water removal restriction process, the lower limb lifting device 400 may cause the abdominal compression device 300A to perform the repetitive compression process, and the lower limb lifting device 400 may perform the lower limb lifting process. Alternatively, the abdominal compression device 300A may have the function of the lower limb lifting device 400, and the abdominal compression device 300A may perform the repetitive compression process and the lower limb lifting process.

[0119] In the first embodiment, the control device 100 acquires blood pressure information from the blood pressure sensor 270 included in the dialysis device 200. The control device 100 may acquire blood pressure information from a blood pressure sensor independent of the dialysis device 200 and the control device 100, or from a blood pressure sensor included in the control device 100.

[0120] In the first embodiment, an example has been described in which the water removal restriction process is a process for maintaining a state in which the water removal speed is reduced. The water removal restriction process may be a process for maintaining a state in which water removal is stopped. In this case, the amount of water removed during the water removal restriction process decreases, but the blood pressure of the patient 50 during the water removal restriction process further increases.

[0121] In the second embodiment, an example has been described in which the lower limb lifting device 400 lifts the lower limbs of the patient 50. The lifting of the lower limbs of the patient 50 may be achieved manually. For example, the control device 100A causes the display unit 13 to display that the lower limbs of the patient 50 should be lifted before instructing the abdominal compression device 300A to start executing the repetitive compression process. In this case, for example, a nurse may manually lift the lower limbs of the patient 50 in accordance with the display on the display unit 13.

[0122] In the first embodiment, an example has been described in which the pressing body 350 including five bags 352, each of which is provided with an air supply tube 353, is used as the pressing body for pressing the lower body of the patient 50. Other pressing bodies may be used. For example, a pressing body in which five bags 352 are connected inside the bag support part 351 and one air supply tube 353 is provided for each of the five connected bags 352 may be used. In addition, it is needless to say that the number of bags 352 is not limited to five.

[0123] In the first embodiment, an example has been described in which the lower body of the patient 50 is compressed by expanding the compression body 350 by supplying air. The method of compressing the lower body of the patient 50 is not limited to this example. For example, the lower body of the patient 50 may be compressed by expanding the compression body 350 by supplying a gas other than air or a liquid. In addition, the lower body of the patient 50 may be compressed by tightening with an elastic body such as a spring or rubber.

[0124] In the above embodiment, the control unit 11 functions as each unit shown in Figs. 6 and 15 by the CPU executing a program stored in the ROM or the storage unit 12. However, in the present disclosure, the control unit 11 may be dedicated hardware. The dedicated hardware is, for example, a single circuit, a composite circuit, a programmed processor, an ASIC (Application Specific Integrated Circuit), an FPGA (Field-Programmable Gate Array), or a combination thereof. When the control unit 11 is dedicated hardware, the functions of each unit may be realized by individual hardware, or the functions of each unit may be realized together by a single piece of hardware. In addition, some of the functions of each unit may be realized by dedicated hardware, and the other parts may be realized by software or firmware. In this way, the control unit 11 can realize each of the above-mentioned functions by hardware, software, firmware, or a combination thereof.

[0125] By applying an operation program that specifies the operation of the control device 100, 100A according to the present disclosure to a computer such as an existing personal computer or information terminal device, it is also possible to make the computer function as the control device 100, 100A according to the present disclosure. In addition, the method of distributing such a program is arbitrary, and for example, the program may be distributed by storing it in a computer-readable recording medium such as a CD-ROM (Compact Disk ROM), a DVD (Digital Versatile Disk), an MO (Magneto Optical Disk), or a memory card, or may be distributed via a communication network such as the Internet.

[0126] Various embodiments and modifications of the present disclosure are possible without departing from the broad spirit and scope of the present disclosure. The above-described embodiments are for explaining the present disclosure and do not limit the scope of the present disclosure. That is, the scope of the present disclosure is indicated by the claims, not the embodiments. Various modifications made within the scope of the claims and the scope of the disclosure equivalent thereto are considered to be within the scope of the present disclosure. [Explanation of symbols]

[0127] 11,102,102A control unit, 12 memory unit, 13,220,320,420 display unit, 14,230,330,430 operation reception unit, 15,240,340,440 communication unit, 50 patient, 100,100A control device, 101 blood pressure drop detection unit, 103 dialysis control unit, 104 compression control unit, 105 blood pressure rise detection unit, 106 elevation control unit, 200 dialysis device, 210 dialysis control unit, 250 dialysis fluid supply device, 260 dialysis machine, 265 drain tank, 270 blood pressure sensor, 281 blood circulation pump, 282 negative pressure pump, 291,292,293,294,295,296 piping, 300 lower body compression device, 300A abdominal compression device, 310 Air pressure control unit, 350, 350A compression body, 351 bag support unit, 351A expansion unit, 351B, 351C mounting unit, 352, 352A, 352B, 352C, 352D, 352E, 352F bag body, 353, 353A, 353B, 353C, 353D, 353E, 353F air supply tube, 361 compressor, 362 air tank, 363 pressure reducer, 364 electropneumatic regulator, 365 exhaust valve, 366 relief valve, 367 air pressure sensor, 368 compression pressure sensor, 400 lower limb lifting device, 410 drive control unit, 450 placement stand, 451 fixed unit, 452 inclined unit, 453 lift unit, 454, 455 rotating shaft, 460 Drive circuit, 470 motor, 480 encoder, 1000,1000A dialysis system

Claims

1. a blood pressure drop detection means for detecting when the blood pressure of a patient falls below a first reference value during artificial dialysis of the patient by the dialysis device; and a control means for causing the dialysis device to temporarily execute a water removal restriction process involving a reduction in the water removal rate or a stop of water removal in the artificial dialysis when the blood pressure drop detection means detects that the blood pressure of the patient has fallen below the first reference value, and causing the compression device to execute a repetitive compression process involving repetitive compression of the lower body of the patient or repetitive compression of the abdomen of the patient while the lower limbs of the patient are being raised. Control device.

2. When the blood pressure drop detection means detects that the blood pressure of the patient has fallen below the first reference value, the control means controls the dialysis device and the compression device so that a period during which the dialysis device performs the water removal restriction process and a period during which the compression device performs the repetitive compression process overlap. The control device according to claim 1 .

3. When the blood pressure drop detection means detects that the blood pressure of the patient has fallen below the first reference value, the control means causes the dialysis device to start the water removal restriction process, and then causes the compression device to start the repeated compression process. The control device according to claim 2.

4. a blood pressure rise detection means for detecting when the blood pressure of the patient has reached or exceeded a second reference value which is higher than the first reference value; The control means causes the dialysis device to start the water removal restriction process, and then when the blood pressure increase detection means detects that the patient's blood pressure has reached the second reference value or higher, causes the dialysis device to end the water removal restriction process. A control device according to any one of claims 1 to 3.

5. A dialysis machine that removes fluids accumulated in the patient's body through artificial dialysis; A compression device that performs a repetitive compression process involving repetitive compression of the patient's lower body or repetitive compression of the patient's abdomen while the patient's lower limbs are being raised; a blood pressure drop detection means for detecting when the blood pressure of the patient falls below a first reference value during artificial dialysis of the patient by the dialysis device; and a control means for causing the dialysis device to temporarily execute a water removal restriction process involving a reduction in the water removal rate or a stop of water removal in the artificial dialysis when the blood pressure drop detection means detects that the blood pressure of the patient has fallen below the first reference value, and causing the compression device to execute the repetitive compression process. Dialysis system.

6. A control method executed by a control device that controls a dialysis device and a compression device, comprising: When a drop in the blood pressure of the patient is detected during artificial dialysis by the dialysis device, the dialysis device is caused to temporarily limit the removal of water during the artificial dialysis, and the compression device is caused to repeatedly compress the lower body of the patient, or to repeatedly compress the abdomen of the patient while the patient's lower limbs are being raised. Control methods.

7. Computer, a blood pressure drop detection means for detecting when the blood pressure of the patient falls below a first reference value during artificial dialysis of the patient by the dialysis device; When the blood pressure drop detection means detects that the blood pressure of the patient has fallen below the first reference value, the control means causes the dialysis device to temporarily execute a water removal restriction process involving a reduction in the water removal rate or a stop of water removal in the artificial dialysis, and causes the compression device to execute a repetitive compression process involving repetitive compression of the lower body of the patient or repetitive compression of the abdomen of the patient while the patient's lower limbs are being raised. program.

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