CN105169509A - 液体清除治疗的电解质和pH值的监测 - Google Patents

液体清除治疗的电解质和pH值的监测 Download PDF

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Publication number
CN105169509A
CN105169509A CN201510511657.9A CN201510511657A CN105169509A CN 105169509 A CN105169509 A CN 105169509A CN 201510511657 A CN201510511657 A CN 201510511657A CN 105169509 A CN105169509 A CN 105169509A
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blood
liquid
sensor device
concentrated solution
electrolyte
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CN105169509B (zh
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马丁·T·格伯
约翰·E·伯恩斯
S·吕
曼达·R·文卡特斯
布莱恩特·J·普迪尔
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Medtronic Inc
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Medtronic Inc
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Abstract

使用包括在一血液液体清除阶段监测血液pH值或血液电解质水平的指标，并根据监测到的指标调整该阶段中采用的透析液或置换液中的pH缓冲液或电解质的浓度。血液液体清除系统可以采用传感器装置，该传感器装置在一血液液体清除阶段监测血液pH值或电解质水平，以调整液体参数。

Description

液体清除治疗的电解质和pH值的监测
相关申请
本申请要求申请日为2012年3月20日，申请号为13/424,479的美国专利申请的优先权，该美国专利申请要求申请号为61/480,539,61/480,544，61/480,541,61/480,535，61/480,532，61/480,530，以及申请号为61/480,528的美国临时申请的优先权，所述各优先权临时申请案的申请日均为2011年4月29日。所述各临时申请与本申请公开的内容不相矛盾的部分在此全部引用纳入本申请。
技术领域
本说明书大致涉及用于监测病人的电解质或pH值的指标的装置、系统和使用，该指标表征了病人(例如肾脏疾病或心脏衰竭患者)的血液净化或液体清除。
背景技术
接受血液透析或从血液中清除溶质和液体的其它治疗的病人经常会死于心脏并发症。很多因素可能导致这种死亡，包括由于这些病人体内血液液体量增加而在心脏上施加的压力。在一些情况下，液体浓度增加以及无法将废物从血液中清除也会导致电解质和pH值不平衡，这将影响心脏的收缩力和效率。进一步地，在血液透析或其它液体清除治疗期间，血液的液体量或pH值或电解质浓度的快速变化可能在心脏上施加额外的压力，并可能导致接受血液液体清除治疗病人的高发病率。
当病人到达一个需要进行常规血液液体清除治疗的值时，病人接受定期检查，以使医疗服务提供者可以设定血液液体清除治疗的各种参数，比如，液体清除的分布图、所采用的透析液或置换液的成分等等。根据现行的医疗标准，这些检查通常一个月进行一次。
血液透析或类似的治疗可以每周进行3至4次。这样，在改变处方(prescription)或参数前，病人可能接受10至15次或更多次血液液体清除阶段(session)。也有可能，例如在设定处方后的几天或几周后，处方的透析液电解质和pH缓冲液成分将不适合病人。因此，可能希望更频繁地确定用于各血液液体清除阶段的液体的电解质浓度或pH值是否合适。另外，可能希望在一个血液液体清除阶段中以可以改善病人健康并减少发病率的方式来调节液体浓度或成分。
发明内容
本说明书还公开了用于监测需要进行血液液体清除治疗的病人体内pH值或电解质的指标的装置、系统和使用。监测可以发生在一个血液液体清除阶段中，缓冲液或电解质的浓度或成分可以根据在血液液体清除阶段中所获得的监测数据进行调节。通过监测pH值或电解质，可以在一个阶段中调节透析液或置换液以提高病人的安全。
在此描述的各个实施例中，一种使用包括为一需要血液液体清除治疗的病人启动一血液液体清除治疗。该治疗包括使用一选自一透析液或置换液的液体。该液体具有一初始的pH缓冲液成分或电解质成分。该使用还包括监测一指标，该指标是关于病人在血液液体清除阶段中的血液电解质浓度或血液pH值的，以及根据监测到的指标的一值调节液体的pH缓冲液成分或电解质成分。该监测可以是对流经血液液体清除装置之前或之后的血液进行的，或者是对从血液中清除的液体进行的。在某些实施例中，将从对流经血液液体清除装置之前或之后的血液进行的监测所获得的数据与从流经血液液体清除装置之前或之后的液体(比如透析液)所获得的数据进行比较，并且根据这个比较，调节液体的pH缓冲液成分或电解质成分。
在实施例中，一系统，包括一血液液体清除装置，其具有(i)一入口，用于接收来自病人的血液，(ii)一出口，用于将来自病人的血液送回，(iii)一中间装置(medium)，用于清除血液中的液体和污物，该中间装置设在所述入口和第一出口之间的位置，以及(iv)一液体源，用于运输(carrying)一液体，该液体选自透析液和置换液，如果该液体是透析液，所述液体源将该液体运输至所述中间装置，如果该液体是置换液，在血液流出中间装置后，所述液体源将该液体运输至血液。所述系统还包括：(i)一浓缩液源，用于容纳一包含浓缩的电解质或pH缓冲液的浓缩溶液；(ii)一浓缩液流量控制元件，用于控制浓缩溶液进入液体源的速度；(iii)一传感器装置(sensor)，用于监测一血液电解质浓度指标或血液pH值指标；以及(iv)电子控制装置，可操作地与所述传感器装置和所述浓缩液流量控制元件通信连接，该电子控制装置设置为通过该浓缩液流量控制元件根据从所述传感器装置获得的数据来调节浓缩溶液进入液体源的速度。
在实施例中，一系统，包括：(i)一中间装置壳体，其限定一主腔；(ii)一血流清除膜，设置在该壳体中，密封地将主腔分成第一和第二腔体；(iii)一第一入口和一第一出口，与第一腔体液体连通，其中所述系统设置为使血液从第一入口进入第一腔体，并且从第一出口流出第一腔体；(iv)一第二入口和一第二出口，与第二腔体液体连通，其中所述系统设置为使透析液从第二入口进入第二腔体，并且从第二出口流出第二腔体；(v)一透析液再生中间装置，与一透析液流动路径液体连通，并且设置在透析液流动路径上位于第二入口和第二出口之间；(vi)一浓缩液源，用于容纳一包括浓缩电解质或pH缓冲液的浓缩溶液；(vii)一浓缩液流量控制元件，用于控制浓缩溶液进入透析液再生中间装置下游和第二入口上游之间的透析液流动路径的速度；(viii)一传感器装置，设置为用于监测一指标，该指标是关于透析液再生中间装置下游和第二入口上游之间的透析液流动路径中的透析液的电解质浓度或pH值的；以及(ix)电子控制装置，可操作地与所述传感器装置和浓缩液流量控制元件相连接，其中所述电子控制装置设置为，根据从所述传感器装置获得的数据，通过所述浓缩液流量控制元件来调节浓缩溶液进入透析液流动路径的速度。
在此所描述的所述系统、装置和使用的一个或多个实施例较之现有用于病人的血液液体清除的系统、装置和使用具有一个或多个优势。通过阅读下面的详细描述，这些优势对本领域的技术人员来说将是显而易见的。
附图说明
这些附图构成了本说明书的一部分，与说明书一起示出了本发明的几种实施方式，用来解释本发明的原理。附图只用于解释本发明的实施例，并不构成对本发明的限制。
图1-图3是示意性框图，其示出了血液液体清除装置与一病人的交互，示出了血液流动(虚线箭头)和液体流动(实线箭头)，该血液液体清除装置在这里所描述的各种实施方式中均可能用到。
图4是一示意性框图，其示出了一传感器装置的一个实施例所选定的一些元件。
图5-图6是示意性框图，其示出了传感器装置和病人与一血液液体清除装置之间的血液流动。
图7-图8是示意性框图，其示出了流动路径和一些控制机构(闭环：图7；开环：图8)，该控制机构用于根据监测到的pH值或电解质控制浓缩液进入液体的流量，该液体是在一血液液体清除治疗中使用的。
图9-图10是血液液体清除装置的一些元件的示意性框图，它们设置为调节液体的pH值或电解质浓度，以对关于监测到的血液中的pH值或电解质水平的数据作出响应。
图11-图13是流程图，其根据本文所描述的实施例示出了一般使用的概要。
这里所呈现的示意图不是必须按比例的。图中使用相同的数字指代相似的元件、步骤等等。然而，可以理解的是，在一个图中使用一个数字来指代一个元件，并非旨在限制该元件在另一图中也使用相同的数字标号。此外，使用不同的数字来指代元件，并非旨在表示不同标号的元件不能是相同或类似的。
技术方案详述
以下的详细描述引用了附图，附图构成实施方式的一部分，在附图中以示例的方式示出了装置、系统和使用的几种实施方式。可以了解的是，在不脱离本发明的范围和精神的情况下，其它实施方式也可以想到并做出的。因此，下面的详细描述不构成对本发明的限制。
这里所用的所有科技术语除非有特别的说明，都具有本领域的常用含义。此处的定义是为了便于理解这里经常用到的某些术语，并非意在限制本发明的范围。
如在本说明书和后附的权利要求中所用到的，单数形式的“一”和“该”包括具有多个所指物的实施例，除非内容清楚地表示其他含义。
如在本说明书和后附的权利要求中所用到的，用语“或”通常是指包括“和/或”的含义，除非内容清楚地表示其他含义。
如这里所用到的“具有”、“包含”、“包括”或类似的用语，是使用其开放式含义的，通常是指“包括，但不限于”的意思。
如这里所用到的“需要进行一血液液体清除治疗的病人”是一已经接受、正在接受或可能会接受至少一个血液液体清除阶段的病人。通常，这些病人是液体负荷过多的病人，比如患有心力衰竭、慢性肾脏疾病或急性肾衰竭的病人。通常这些病人是慢性肾脏疾病第3期至第5期的病人，对利尿剂无反应或反应低等等。
如这里所用到的“血液液体清除治疗”或类似语是指一个从病人的血液里将液体清除再将血液送回到病人体内的过程。在大多数情况下，血液也被净化，即从血液中清除废物，被净化的血液返回到病人体内。血液液体清除治疗的实例包括超滤、血液过滤、血液透析、血液透析滤过、腹膜透析等等。任何需要进行血液液体清除的病人都可以从这里所描述的装置、系统以及使用中受益。
本说明书还涉及用于监测需要进行一血液液体清除治疗的病人体内pH值或电解质浓度的指标的装置、系统和使用。在实施例中，传感器装置被构造和设置为，用以监测以下一种或多项：
(i)病人的血液在进入血液液体清除装置的一液体清除或净化中间装置前的pH值或电解质；
(ii)病人的血液在离开中间装置后且返回病人体内前的pH值或电解质；
(iii)病人的血液在流过中间装置后，从病人的血液中清除的液体的pH值或电解质；
(iv)液体，比如透析液，在进入中间装置前的pH值或电解质；
(v)浓缩液添加的液体上游或下游的pH值或电解质，该浓缩液用于改变液体(例如透析液或置换液)的成分；
(vi)诸如此类的pH值或电解质。
关于传感器装置的放置和这些传感器装置的使用的进一步讨论将在后面进行。首先，先对血液液体清除装置或系统进行简单介绍，该装置或系统可以根据本文的教示来使用。
任何用于将液体，或液体和污物，从血液中清除的适宜的装置或系统都可以根据本文的教示来使用。这些装置或装置的部件可以是传统的大型顾问式的，可穿戴的，或可植入的。
图1-图3示出了一些示例装置和系统的方框图。如图1所示，血液可以从病人10抽出，液体经过一血液液体清除装置100被清除，并流返至病人10。清除的液体可以被转移。在一些实施例中，血液液体清除装置100或系统或其部件被植入，清除的液体可以被转移到病人的膀胱。血液液体清除装置100实例是超滤和血液过滤装置，该装置可以如图1所示来运行。这些可以根据本文的教示使用的装置和其部件的实例在本领域内是公知的。可以理解的是，也可以采用将透析液引入到腹膜腔内的腹膜透析。
在其中一些装置中，如果用装置100以过大的速度或量将液体从血液中清除，可以将置换液导入病人血液中。置换液可以在液体清除前加入原始血液中，也可以在血液经过初始液体清除后、流返至病人的心血管系统前加入到血液中。优选地，置换液在初始液体清除后加入到血液中。置换液的pH值和电解质浓度可以设定或调节，例如，如下面更详细的描述，根据对病人pH值和电解质的监测来设定或调节。
如图2所示的实施例，血液液体清除装置100可以采用透析液来帮助病人血液中污物的清除，并且保持合适的pH值和电解质平衡。透析液的pH值或电解质浓度可以设定或调节，例如，如下面更详细的描述，根据pH值或电解质的监测来设定或调节。使用过的透析液和从血液中清除的液体可以被转移。在一些实施例中，尤其是在血液液体清除装置100或系统或其部件是可穿戴的或可植入的实施例中，使用过的透析液和清除的液体或它们的一部分可以再生出(虚线所示的再生系统150)新的透析液，以在血液液体清除治疗中再利用。透析液再生的一种系统是REDY系统，比如在Roberts,M，“再生透析(REDY)吸附剂系统”(theregenerativedialysis(REDY)sorbentsystem)，《肾脏病学》(Nephrology)4:275-278,1998中描述的，该系统可以用在这里所描述的实施例中，或简单修改后用在这里所描述的实施例中。如图2所示，可以向再生透析液中加入一浓缩液，以把再生透析液的pH值和电解质调节到一个像新透析液一样适合再使用的量。
不管透析液是否再生，以图2的实施例所示的方式运行的系统和装置包括血液透析和血液透析滤过系统。根据本文的教示可以采用的这些装置及其部件的实施例在本领域是公知的。可以理解的是，也可以采用将透析液导入到腹膜腔内的腹膜透析。
如图3所示，当图2的血液液体清除装置100以过高的速度从血液中清除液体时，在液体清除的上游或下游，可以将置换液引入病人的血液中，例如，如上文与图1相关的描述。
不管采用的装置或血液液体清除治疗是怎样的，重要的是要保证血液pH值和电解质浓度在合适的范围内。如果血液电解质浓度不在合适的范围内，心脏并发症、效率以及类似的问题可能会发生。如果pH值不在一个合适的范围内，可能导致酸中毒，这会导致细胞膜的破坏和蛋白质的变性。不管发生什么情况，如果血液的电解质和pH值范围控制不当，病人的健康可能处于危险中。例如，猝死和心脏死亡(包括充血性心力衰竭、心肌梗死导致的死亡以及猝死)在血液透析病人中是常见的。参见Bleyer等人，“血液透析病人猝死和心脏死亡的比例”(Suddenandcardiacdeathratedinhemodialysispatients)，《国际肾脏期刊》(KidneyInternational),(1999),55:1552-1559。
因此，血液透析、超滤等等的一个目的是为了保证病人的血液pH值和电解质浓度在可接受的范围内。在一个血液液体清除阶段中的pH值和血液电解质浓度的通常期望范围值在下面的表1中列出。如表1所示，各种酸或碱(或其盐或水合物)的浓度在决定血液的pH值时通常是很重要的。因此，这些酸、碱的常用目标浓度列在表1中。
表1：pH值和电解质的常用目标范围(参见《医学外科护理》(MedicalSurgicalNursing),2007年第7版)
目标范围
pH 7.35-7.45
磷酸盐 2.8-4.5mg/dL
碳酸氢盐 22-26mEq/L
Cl- 96-106mEq/L
Mg2+ 1.5-2.5mEq/L
Na+ 135-145mEq/L
K+ 3.5-5.0mEq/L
Ca2+ 4.5-5.5mEq/L
然而，可以理解的是，某一病人的目标值可能与表1中所列的一个或多个电解质或pH值的值不同。也可以理解的是，缓冲液通常用于维持适当的血液pH值。
一些可以用于诸如置换液或透析液的液体中的合适的缓冲液包括碳酸氢盐，醋酸盐，柠檬酸盐，乳酸盐，氨基酸和蛋白质缓冲液。缓冲液的浓度和组成及其组分可以根据监测到的病人血液的pH值调节。类似地，在置换液或透析液中的电解质(例如钠、钾、钙、氯化物)的浓度，可以根据监测到的电解质的水平设定或修改。
任何适合的传感器装置(sensor)都可以用来监测pH值或电解质。例如参见图4，一框图示出了一传感器装置200可能包括的一些部件。在图4中传感器装置200是以一个独立的装置示出，但可以理解的是，该装置，其一个或多个部件可以装入其它装置中，例如一血液液体净化装置。图4中所画的传感器装置200具有一壳体299(如果该传感器装置或其部件装入其它装置中，其能够与其它装置共用该壳体)，其用于容纳各种电子部件296，297，289，295。感测电路296(比如模数转换器、带通过滤器等等)可操作地与电源297(也可能是共用的)和电子控制装置295(可能是共用的)耦合，电子控制装置295包括一处理器294和一用于存储感测到的数据和处理器指令的存储器293。感测电路296也通过导线207可操作地耦合到传感器(transducer)205(例如一离子选择性电极)。在一些实施例中(未示出)，装置200是没有导线的，传感器205或离子选择性电极穿过壳体299暴露在外面。电子控制装置295可操作地与电源297以及通讯电路289耦合，通讯电路用于与其它外部装置通讯。在传感器装置200是一个独立装置的情况下，通讯电路可以用于与一血液液体清除装置或一个与血液液体清除装置通讯连接的装置进行通讯，以将从传感器装置获得的数据传送到血液液体清除装置。
任何合适的传感器(transducer)都可以用来检测pH值或电解质。在实施例中，该传感器是一离子选择性电极，其配置为检测H+离子，K+离子，Na+离子，Ca2+离子，Cl-离子，磷酸盐离子，镁离子，醋酸盐离子，氨基酸离子等等。这种电极以及采用这种电极的传感器装置(sensor)部件在本领域内是公知的，并可以根据本文的描述用于监测或变化后用于监测。一种pH值传感器装置的实例是美敦力公司(Medtronic,Inc.)pH值传感器装置。一种钾离子选择性电极的实例是ThermoScientificPotassium离子选择性电极的其它实例在诺华生物制药公司(NovaBiomedical)生产的CCXStat中有。
在一些实施例中，采用一个或多个传感器装置(sensor)来检测一个或多个离子以测量血液中的pH值或电解质。在一些实施例中，一个传感器装置可能有多个传感器(transducer)，即使没有导线，也可以监测不止一种离子。通过测量多种离子，可以对各电解质的水平或血液成分有更深入的了解。例如，某些病人在某种情况下，一种电解质可能处于升高的水平，而另一种可能处于下降的水平。在一些实施例中，用多个传感器装置测量同一种离子，目的是确认和重复测量结果，这能够提高可靠性和精度。在一些实施例中，用于同一种离子的传感器装置可以构造为准确地测量离子浓度的不同范围值。在一些实施例中，多个传感器设置在一个单元中，这方便了数据收集和电路设计，因为可以在一个地方同时收集所有的数据。另外，多个传感器可以共用同一液体收集装置(例如在植入病例中的一微量透析仪)，并且如果有需要或想要，可以共用同一数据处理和存储部件。
基于监测电解质或pH值的目的，一传感器装置(sensor)(或传感器(transducer))可以放在任意合适的位置。例如参见图5，其描绘一个血液液体清除系统和传感器装置的实施例。可以采用一个或多个传感器装置200A，200B。如图5所示，一pH值或电解质传感器装置200A可以设于病人的体外并且设置为在血液进入血液液体清除装置100前(或进入血液液体清除中间装置前，后面会更详细地讨论)监测血液的pH值或电解质水平。例如，传感器装置200A可以设置为，使传感器置于一导管内，该导管将血液从病人10运输至血液液体清除装置100或血液液体清除中间装置。
从传感器装置200A获得的数据提供了一病人10实际状态的指征，该传感器位于液体清除装置100或血液液体清除中间装置的上游。随着一血液液体净化阶段的进展，从位于液体清除装置100或血液液体清除中间装置上游的传感器装置200A获得的数据可以用于确定血液的pH值和电解质是否正接近于目标范围，或确定病人体内的pH值和电解质发生变化的速度，作为血液液体清除治疗的结果。然而并不意在受本理论的限制，pH值或电解质浓度变化过快可以导致病人血压过低或猝死是有可能的，这已经在接受血液液体清除治疗的病人群体出现过。通过监测和控制血液液体清除阶段中病人的血液中pH值和电解质变化的速度，可能能够降低病危(crashing)或猝死的发生率。
在一些实施例中，传感器装置(sensor)200B设于病人10的体外并且设置为监测血液在流出血液液体清除装置100后(或流出血液液体清除中间装置后)且返回病人10体内前的pH值或电解质水平。例如，传感器装置200B可以这样设置，将传感器(transducer)置于一导管内，该导管将血液从血液液体清除装置100(或中间装置)运输至病人10。这种下游的传感器装置200B可以用来保证将要返回病人体内的血液的pH值和电解质水平不超出范围。如果检测到的水平超出范围或将要超出范围，可以调节液体(透析液或置换液)pH值和电解质浓度，从而避免流回病人10体内的液体可能导致或加剧心脏问题，该心脏问题与电解质或pH值的水平过高或过低有关联。
在一些实施例中，系统既采用一上游传感器装置200A，又采用一下游传感器装置200B。采用这样的系统，可以将上游和下游测量到的pH值或电解质水平进行比较，比较后的数据可以用于调节在一血液液体清除阶段中采用的液体的pH值或电解质浓度或成分。比较后的数据也可以用于确定血液电解质浓度或pH值的变化速度。举例来说，在一血液液体清除阶段之前或在这一阶段的前期，病人通常是液体过剩的并且电解质浓度可能较低(由于液体量的增加)。当病人的电解质水平较低时，可能比较恰当的是，使电解质浓度比将要流回病人体内的电解质目标浓度略高。然而，随着病人的电解质水平(由上游的传感器装置200A测得)接近目标水平，流回的血液的电解质水平(由下游的传感器装置200B测得)应当在目标范围内。同时监测上游和下游顾及到了进程的调节和检查，而只监测一个则可能无法实现。
现在参见图6，其示出了一个系统，该系统在可替代地或另外的位置采用了传感器装置200C，200D，200E，200F。可以采用一个或多个这些传感器装置200C，200D，200E，200F。系统也可以如与图5相关的描述所述的采用一下或多个下游传感器装置，但在图6中没有示出。本文在此给出了传感器装置200C，200D，200E，200F几种可能的配置和使用的简单介绍。然而，可以理解的是，采用与下面的描述不同的配置，也可以获得有意义的数据。
在实施例中，该系统(例如在图6中所示的系统)采用了两个上游传感器装置200B，200C。第一上游传感器装置200B被设置为监测流出血液液体清除装置100或中间装置后但加入置换液之前的血液中的pH值或电解质水平。第二上游传感器200C装置被设置为监测加入置换液体后但血液返回病人10体内前的血液中的pH值或电解质水平。第一上游传感器200B可以用来确定pH值或电解质水平需要进行哪些调节，而第二上游传感器200C可以用来校验做出的恰当的调节以在血液返回到病人体内前达到期望的pH值或电解质浓度。
在实施例中，系统采用一传感器装置200E来监测流出血液液体清除装置100或中间装置后从病人的血液中清除的液体的pH值或电解质，该系统也可以包括一传感器装置200D，其构造并设置为监测进入血液液体清除装置100或中间装置之前的液体的pH值或电解质(在所描绘的实施例中，是指透析液)。通过随着液体离开装置100或中间装置而监测的液体pH值或电解质(或在进入装置或中间装置之前和流出装置或中间装置之后的pH值或电解质水平的差值)，流出装置100或中间装置的液体pH值或电解质水平(或pH值或电解质的变化)可以用于预测血液的pH值或电解质水平，而不必直接测量血液中的水平。如果pH值或电解质在液体中测得而不是在血液中测得，并且用于导出或预测血液中pH值或电解质水平或血液的变化，这样的测量结果就是血液pH值或电解质的“指标”。当然，直接在血液中测量的结果也是血液pH值或电解质的指标。
不管采用哪一个传感器装置200A-F(参见图4-图6)，从传感器装置获得的数据都可以用于调节在透析阶段所用的液体的pH值或电解质浓度(例如透析液或置换液)。在某些实施例中，透析液或置换液的浓度是变化的，通过一个或多个传感器装置测得的病人对浓度变化的反应，用于确定怎样最佳地进行下一步调节。其实，系统可以设置为获知什么对某一个病人10最有效。例如，具有不同缓冲液浓度或组分或不同电解质浓度的透析液或置换液可以在一初始血液液体清除阶段或在血液液体清除阶段的前期使用。病人对于这些不同液体的反应能够通过传感器被监测到，而且系统能够获知什么对该病人最有效。例如，系统能够确定不同液体的使用是否使病人血液的水平接近目标水平或偏离目标水平，以及该水平接近或偏离目标范围的速度。根据这些初始阶段，系统可以开始预测如何为病人对某一监测到的pH值或电解质水平作出反应，并相应地调节液体的pH值或电解质浓度。
液体的pH值或电解质浓度(透析液或置换液)可以以任何适合的方式进行调节。例如参照图7-8，其示出了用于调节液体的pH值和电解质浓度的一闭环系统(图7)以及一开环系统(图8)的实施例的一些代表性部件。参见图7，来自一个或多个传感器装置200的数据显示在电子控制装置495上，电子控制装置设置为控制流量控制元件415，425，435，例如阀。该电子控制的流量控制元件415，425，435与浓缩的电解质或缓冲溶液410，420，430的供给管道液体连通，并与液体管道440液体连通，该液体管道440可以是一用于运输新透析液的导管或一用于运输置换液的导管。该电子控制的流量控制元件415，425，435通过电子控制装置495控制浓缩液410，420，430流进液体管道440的速度。浓缩液410，420，430被加入到体相流体(bulkfluid)400中，以调节体相流体(以及血液)中电解质的浓度或pH值。
参见图8，来自一个或多个传感器装置200的数据被处理，且适当的信息显示在一显示器600上，该显示器600可以是血液液体清除装置的一部分，或一独立的计算机等等。医疗服务提供者可以使用显示在显示器600上的信息来调节电解质的浓度或pH值。例如，这可以通过一输入装置500传输一合适的指令给电子控制装置来实现。任何合适的输入装置500都可以采用。例如输入装置500可以是一键盘，一计算机，一平板计算机，一个人数据助手，一医师程序器等等。在某些实施例中，该输入装置500就是该显示器600，例如在显示器600是一触屏装置的情况下。不管指令如何输入，电子控制装置495都能够控制流量控制元件415，425，435，从而控制流入体相流体400的浓缩液410，420，430的量，体相流体400可以是透析液或置换液。
可以使用任何数量的合适的浓缩液。例如，当确定病人血液内的电解质较低而加入较多量的浓缩液时，以及当确定病人血液内的电解质较高而加入较少量的浓缩液时，一种浓缩物可能是足够的。例如当希望独立地控制pH值和电解质浓度或独立控制不同电解质的浓度时，可能要用到一种以上的浓缩物。在实施例中，浓缩物的数量与监测的离子种类(pH值和电解质)的数目是相同的。
如图7-8所示并且如上所述，控制元件415，425，435可以是任何适合的控制元件，例如电子控制阀，电子控制泵装置等等。
任何合适的系统可以被设置为如图7和图8所示，用于根据从一个或多个传感器装置获得的数据对pH值或电解质的调节进行控制。作为示例，图9和图10示出了系统的两个实例的所选择的部件。图9中的系统示出了对一浓缩液进入置换液的流量进行的控制，图10中的系统示出了对一浓缩液进入透析液的流量进行的控制。
现在参见图9，其描绘的装置100包括在血液返回到病人体内前向血液中加入置换液的一流动路径。该装置100包括一入口110，用于接收来自病人的血液，一出口140，用于将血液返回至病人体内。在入口110和出口140之间的流动路径上设有一血液流量控制元件120，以及一用于从血液中清除液体和污物的中间装置。该血液流量控制元件120与电子控制装置150可操作地耦合，该电子控制装置150提供指令以控制血液流经中间装置130的速度。通过中间装置130从血液中清除的液体和污物可以由出口180排出。
图9中示出的装置100还包括一入口197，用于接收体相置换液，以及一置换液流量控制元件195，其与入口通信连接，并且设置为控制置换液加入到血液中的速度。电子控制装置150与置换液流量控制元件195可操作地耦合，并且设置为控制置换液流量控制元件195向血液中加入液体的速度。该装置100还包括(i)一入口401，用于接收调节体相置换液的pH值或电解质浓度的浓缩液，以及(ii)一浓缩液流量控制元件415，其与入口401通信连接，并且设置为在血液返回到病人体内前控制浓缩液加入到置换液或血液中的速度。优选地，浓缩液加入到置换液早于置换液加入到血液中(如图所示)，这样，浓缩液可以在加入到血液之前被混合或稀释。该装置可以包括一混合器(未示出)，其用于在加入到血液之前混合浓缩液和体相置换液。
在图9中所示的装置中，电子控制装置150与浓缩液流量控制元件415可操作地耦合，并且设置为根据来自一个或多个传感器装置200的数据控制浓缩液流量控制元件415向置换液或血液中加入液体的速度，该传感器装置监测pH值或电解质水平(例如如上所述)。通过控制浓缩液加入到置换液或血液中的速度，就能够控制回流血液的浓度或pH值(或缓冲量(bufferingcapacity))。
现在参照图10，图中与图12中相同或类似部件的编号相同，其示出了一血液液体清除装置100的所选定的部件的示意框图。在图10所示的实施例中，装置具有一入口110，用于接收来自病人的血液，一血液流量控制元件120与入口110通信连接，并且设置为控制血液流经中间装置130以从血液中去除液体和污物的速度。该装置还包括一出口140，其与中间装置130连通，用以将血液返回到病人体内。在所示的实施例中，中间装置130的部件具有一壳体139，其限定了一主腔131。一半渗透过滤器135，例如一血液过滤或血液透析膜，将主腔密封地分成两个腔体133,137；133用于血液流动，137用于透析液流动(以及来自血液的流经过滤器135的液体和废物)。
在图10中所示的实施例中，使用过的透析液经过透析液再生中间装置402或部件再生，例如REDY再生中间装置和成分等等，以产生体相透析液。该装置还具有一出口180，其与中间装置130连通，用于将从血液中清除的液体转移出该装置。一流量调节元件700(比如一阀)与电子控制装置150可操作地耦合，并设置在中间装置130和出口180之间的流动路径上，以用来控制流出该装置的液体量(因为部分液体已经再生)。通常，再生中间装置或部件402从透析液中清除大量的pH缓冲液或电解质。因此，含有浓缩电解质和pH缓冲液的浓缩液在透析液再次进入中间装置130之前被加入到再生的透析液中。在某些实施例中，一传感器装置299设在再生中间装置402的下游，用来监测再生透析液成分水平。该传感器装置299可以是一pH值或电解质传感器，从传感器装置299获得数据可以用于确定向再生液体中加入多少浓缩液(该数据可以提供给电子控制装置150)。该传感器装置299可以是一监测一血液废物(比如尿素)的传感器装置，以确定该再生中间装置402是否正常工作。一废物水平增多或可检出可能表示再生中间装置402或部件可能需要更换或再生。
在该示出的实施例中，浓缩液410存放在一储液器410中，储液器具有一入口401，其允许不时地向储液器410补充浓缩液。浓缩液加入再生透析液的速度根据来自传感器装置200的数据由浓缩液流量控制元件415控制，该浓缩液流量控制元件415与电子控制装置150可操作地耦合，该传感器监测pH值或电解质浓度(例如如上所述)。
图10中的装置100还包括一透析液流量控制元件170，用来控制透析液流入中间装置130的透析液流动腔体的速度。
在示出的实施例中，该装置100还包括一负压控制元件190，其与中间装置部件130的透析液流动腔体相连接。该负压控制元件190可以包括一泵或类似物，其可以用于产生或改变一穿过所述膜的压力差，来控制液体从流经中间装置部件130的血液里清除的速度。
电子控制装置150可以包括一处理器，一存储器等，其与血液流量控制元件120、透析液流量控制元件170和负压控制元件190可操作地耦合，且构造为控制该血液流量控制元件120、透析液流量控制元件170和负压控制元件190。通过协调控制这些元件，可以控制液体从血液中清除的速度。可以理解的是，装置100不需要具有图10所示的所有这些控制元件120,170,190以有效控制液体从血液里清除的速度。
如图9和图10所示的各种控制元件120，150，170，195，415，可以使用任何适合的控制元件。例如，可以采用一速度可变或可调的泵。可选地或附加地，可以采用一系列电子控制阀。在某些实施例中，这些阀与具有不同流动阻力的流动路径相连接。
在图9和图10示出了能够通过调节置换液或透析液的pH值或电解质浓度来调节血液电解质或pH值的装置的情况下，可以理解的是，pH值和电解质浓度也能够通过例如调节透析液或血液流经一透析膜的速度来调节。血液和电解质透析液等等之间的穿过所述膜的置换速度将依赖于血液和透析液的流速。因此，如果系统内的透析液电解质浓度或pH值不好调节，可以通过改变血液或透析液流动速度以达到与调节透析液电解质的浓度相类似的效果。
图9和图10示出了部件设置在一个单元内的，可以理解的是，一个或多个部件也可以置于分立的单元内。例如，电子控制装置或其一部分可以置于一个分立的装置内，比如一计算机，一平板计算机，一医师程序器等等。计算机，平板计算机等等可以接收来自传感器的输入信息，确定采取恰当的行动，并指示一血液液体清除装置中适当的部件来执行这一行动。
可以理解的是，这里所述的血液液体清除装置和系统及其部件呈现的目的在于解释说明，而并非限制。不同于这里所描述的部件、装置和系统，或者所述部件、装置和系统的衍生，都可以被采用。另外，以上所示和所述的装置的部件根据具体情况是可以酌情交换位置的、可替代的，或可以加入其它实施例的部件中。进一步地，可以理解的是，在各个附图中，比如图1至图3，图5至图6，所描绘的这些血液液体清除装置是以在病人体外示出的，如果这些装置或其部件是植入病人体内的，这里所呈现的教导也是适用的。
以上所述的装置和系统或其部件，可以用来实现下文所述的和图11至图13所示的使用或部分使用。当然，任何适合的装置或系统都可以用来实现下文所述这些使用或部分使用。可以理解的是，以下关于图11至图13中任意一个所呈现的使用中的各个步骤是可以交换顺序的、可替代的，或可加入到关于图11至图13中另一个所呈现的步骤中去。
现在参见图11，示出的使用包括开始一血液液体清除阶段801，以及监测一血液pH值或电解质浓度的指标810；例如检测血液的pH值或电解质，或检测可以获得血液中的pH值或电解质水平的液体中的pH值或电解质。根据所监测的pH值或电解质指标，可以调节用于血液液体清除阶段的液体(例如透析液或置换液)的pH值或电解质成分或浓度860。例如，如上所述，根据一个或多个监测到的离子种类的当前值或监测到的离子种类的变化速度，调节液体成分。
如图11所示，根据在监测期间810所获得的数据可以持续地、周期性地或间歇性地做出关于pH值或电解质浓度是否超出范围的决定830。例如，可以做出关于pH值或电解质水平是否超出临界值(例如一最高值或一最低值)的结论830。如果确定pH值或电解质在范围内，监测810可以继续。如果确定pH值或电解质在范围外(例如超出了临界值)，可以发出一报警840，以将状况通知病人或医疗服务提供者。有时候，这种状况可能使得血液液体清除阶段中止890；例如如果检测到的pH值或电解质远远在范围值外或超出了升高的临界值。在其它情况下，在对这一状况增加关注的同时继续血液液体清除阶段也可能是合适的。
现在参见图12，示出的使用包括开始一血液液体清除阶段801，以及监测血液液体清除上游815和下游813的一pH值或电解质浓度的指标。可以对比从上游和下游的传感器装置获得的数据，来决定如何调节液体成分860，例如如上所述。
现在参见图13，该示出的使用显示了一种通过改变透析液或血液的流速来调节血液电解质浓度或pH值的使用。该使用包括开始一血液液体清除阶段900，比如一血液透析阶段，以及监测一pH值或电解质的指标910，其可以是在病人体内，在装置的上游，在装置的下游，在装置内等等。根据监测到的数据910，对透析液或血液的流速进行调节920，以调节返回到病人体内的血液中的电解质浓度或pH值。
这里所述的使用，包括图11至图13所示的使用，可以由传感器装置、血液液体清除装置或与传感器或与传感器装置或血液液体清除装置相连接的其它装置完成。这些使用可以是编入该装置的存储器内的逻辑运算或指令，其可以由处理器或其它电子控制装置来完成。优选地，该处理器与装置中合适的控制元件相连接，并且设置为通过程序指令来控制这些元件，这些程序指令由合适的装置执行。可以理解的是，如上文所述，一编写有使一传感器装置、血液液体清除装置或其它适合的装置执行一使用或部分使用的指令的计算机可读介质是可以想到的。该计算机可读介质可以是非瞬时的(non-transitory)，即持续时间长于一瞬间或几秒钟。该介质可以是存储器，比如RAM或ROM，一CD或DVD，闪存等等。
这里公开了使用、系统、装置、计算机可读介质等等的各种变化情况，下面介绍某些情况的概述。
第一种情况，一系统包括：(a)一血液液体清除装置，包括(i)一入口，用于接收来自病人的血液，(ii)一出口，用于返回来自病人的血液，(iii)一中间装置，用于清除血液中的液体和污物，该中间装置设于所述入口和第一出口之间，以及(iv)一液体源，用于运输一液体，该液体选自透析液和置换液，其中，如果该液体是透析液，所述液体源将该液体运输至所述中间装置，如果该液体是置换液，在血液流过中间装置后，所述液体源将该液体运输至血液；(b)一浓缩液源，用于容纳一包含浓缩的电解质或pH缓冲液的浓缩溶液；(c)一浓缩液流量控制元件，用于控制浓缩溶液进入液体源的速度；(d)一第一传感器装置，设置为监测一血液电解质浓度指标或血液pH值指标；以及(e)电子控制装置，其可操作地与所述传感器装置和所述浓缩液流量控制元件通信连接，其中该电子控制装置设置为通过该浓缩液流量控制元件根据从所述传感器装置获得的数据来调节浓缩溶液进入液体源的速度。
第二种情况是第一种情况的一系统，其中所述第一传感器装置设置为监测进入中间装置之前的血液。
第三种情况是第二种情况的一系统，还包括一第二传感器装置，其设置为监测一血液电解质浓度或血液pH值的指标，该第二传感器装置设置为监测流出中间装置之后的血液。
第四种情况是第三种情况的一系统，其中所述电子控制装置可操作地与第二传感器装置连接，并设置为：对比从第一传感器装置和第二传感器装置获得的数据，其中所述电子控制装置设置为：根据从第一传感器装置和第二传感器装置获得的数据的比较结果，来调节浓缩溶液进入液体源的速度。
第五种情况是第一种情况的一系统，其中所述第一传感器装置设置为：在从血液中清除的液体流出中间装置后，监测从血液中清除的液体中的指标。
第六种情况是第五种情况的一系统，其中所述电子控制装置设置为：根据从第一传感器装置获得的数据得到血液pH值或血液电解质浓度。
第七种情况是第五种情况的一系统，还包括一第二传感器装置，其设置为：在透析液进入中间装置之前，监测液体源中的透析液的指标，其中所述电子控制装置与所述第二传感器装置通信连接，并且设置为：对比从第一传感器和第二传感器获得的数据，其中所述电子控制装置设置为：根据从第一传感器和第二传感器获得的数据的对比结果，来调节浓缩溶液进入液体源的速度。
第八种情况是第一种情况的一系统，其中所述第一传感器装置设置为：在血液流出中间装置后以及置换液加入到血液之前，监测血液中的指标。
第九种情况是第八种情况的一系统，还包括一第二传感器装置，其设置为：在置换液加入到血液中后，监测血液中的指标。
第十种情况是第一至第九种情况中任意一种的一系统，其中所述电子控制装置或其部件容置于所述血液液体清除装置的一壳体内。
第十一种情况是第一至第十种情况中任意一种的一系统，还包括一计算机可读介质，其中该计算机可读介质包括指令，该指令使电子控制装置根据从传感器装置获得的数据来控制浓缩液流量控制元件，以调节浓缩溶液进入液体源的速度。
第十二种情况是由一血液液体清除装置或系统实施的一使用，包括：(i)为一需要血液液体清除治疗的病人开始血液液体清除治疗，其中所述治疗包括使用选自一透析液或一置换液的一液体，其中所述液体具有一初始pH缓冲液成分或电解质成分；(ii)监测病人在血液液体清除阶段的血液电解质浓度指标或血液pH指标；以及(iii)根据监测到的指标的一值，调节液体的pH值缓冲液成分或电解质成分。
第十三种情况是第十二种情况的一使用，其中监测所述指标包括：在血液流过一血液液体清除中间装置之前和流过该血液液体清除中间装置之后，监测血液中的指标。
第十四种情况是第十三种情况的一使用，还包括对比在血液流过所述中间装置前和流过所述中间装置后监测到的指标的值，其中调节pH缓冲液成分或电解质成分包括根据对比结果来调节成分。
第十五种情况是第十二至十四种情况中任意一种的使用，其中调节成分包括向液体中加入一浓缩的电解质溶液或缓冲溶液。
第十六种情况是第十二至十五种情况中任意一种的使用，还包括(i)确定被监测指标的值是否超出了一临界值；以及(ii)如果确定被监测指标的值超出了临界值，发出一报警。
第十七种情况是第十二种情况的一使用，其中监测所述指标包括监测从血液中清除的液体中的指标。
第十八种情况是第十七种情况的一使用，还包括根据被监测指标的值确定一血液电解质浓度或pH值，该被监测指标的值是关于被清除出血液的液体的。
第十九种情况是第十七或十八种情况的一使用，其中所述用于血液液体清除治疗的液体是透析液，其中监测所述指标还包括：在透析液进入一血液液体清除中间装置之前监测透析液中的指标，其中该使用还包括：对比从血液中清除的液体中的被监测指标的值和透析液进入血液液体清除中间装置前透析液中的被监测指标的值。
第二十种情况是第十二种情况的一使用，其中所述用于血液液体清除治疗的液体是置换液，其中监测所述指标包括：监测一血液液体清除中间装置下游血液中的指标，以及向血液中加入置换液上游的血液中的指标。
第二十一种情况是第二十种情况的一使用，其中监测所述指标还包括：监测加入置换液下游血液中的指标，其中所述使用还包括：将加入置换液上游所获得的被监测指标的值和加入置换液下游所获得的被监测指标的值进行对比。
第二十二种情况是一系统，包括：(i)一中间装置壳体，其限定一主腔；(ii)一血流清除膜，设置在该壳体中，密封地将主腔分成第一和第二腔体；(iii)一第一入口和一第一出口，与第一腔体液体连通，其中所述系统设置为使血液从第一入口进入第一腔体，并且从第一出口流出第一腔体；(iv)一第二入口和一第二出口，与第二腔体液体连通，其中所述系统设置为使透析液从第二入口进入第二腔体，并且从第二出口流出第二腔体；(v)一透析液再生中间装置，与一透析液流动路径液体连通，并且设置在透析液流动路径上位于第二入口和第二出口之间；(vi)一浓缩液源，用于容纳一包括浓缩电解质或pH缓冲液的浓缩溶液；(vii)一浓缩液流量控制元件，用于控制浓缩溶液进入透析液再生中间装置下游和第二入口上游之间的透析液流动路径的速度；(viii)一传感器装置，设置为用于监测一指标，该指标是关于透析液再生中间装置下游和第二入口上游之间的透析液流动路径中的透析液的电解质浓度或pH值的；以及(ix)电子控制装置，可操作地与所述传感器装置和浓缩液流量控制元件相连接，其中所述电子控制装置设置为，根据从所述传感器装置获得的数据，通过所述浓缩液流量控制元件来调节浓缩溶液进入透析液流动路径的速度。
第二十三种情况是通过一血液液体清除装置或系统实施的一使用，包括：(i)为一需要血液液体清除治疗的病人开始血液液体清除治疗，其中所述治疗包括使用一透析液和作为血液液体清除中间装置的至少一部分的一透析膜，穿过该透析膜，电解质可以在血液和透析液之间交换；(ii)监测在血液液体清除阶段的血液电解质浓度或血液pH的指标；以及(iii)根据被监测指标的值调节透析液或血液的流速。
第二十四种情况是第二十三种情况的一使用，其中监测所述指标包括：在血液流过一血液液体清除中间装置之前和流过该血液液体清除中间装置之后，监测血液中的指标。
第二十五种情况是第二十三种情况的一使用，还包括对比在血液流过所述中间装置前和流过所述中间装置后监测到的指标的值，其中调节透析液或血液流速包括根据对比结果来调节成分。
第二十六种情况是第二十三至二十五种情况中的任意一种的使用，其中监测所述指标包括监测从血液中清除的液体中的指标。
第二十七种情况是第二十三种情况的一使用，还包括根据被监测指标的值确定一血液电解质浓度或pH值，该被监测指标的值是关于清除出血液的液体的。
这样，用于液体清除治疗的电解质和pH值的监测的系统，装置和使用就均被描述了。本领域的技术人员将会认识到在不脱离本公开文本和后附的权利要求限定的精神和范围的情况下，本文所述的优选实施例是可以进行改变或修改的。
在后续的权利要求中，“第一”、“第二”、“第三”等是用来区别元件而不是用来列举元件或限定元件的顺序的。例如，一“第三”传感器不是暗示有三个传感器，而是区别于“第一”传感器。再进一步举例，一“第三”传感器并不必须是排在一“第一”传感器之后的。

Claims (12)

1.一种血液液体清除系统，其包括：
一血液液体清除装置，其包括：(i)一入口，用于接收血液；(ii)一出口，用于返回血液；(iii)一中间装置，用于清除血液中的液体和污物，该中间装置设于所述入口和出口之间；以及(iv)一液体源，用于运输一液体，该液体选自透析液和置换液，其中，如果该液体是透析液，所述液体源将该液体运输至所述中间装置，如果该液体是置换液，在血液流过中间装置后，所述液体源将该液体运输至血液；
一浓缩液源，用于容纳一包含浓缩的电解质或pH缓冲液的浓缩溶液；
一浓缩液流量控制元件，用于控制浓缩溶液进入液体源的速度；
一第一传感器装置，设置为监测一血液电解质浓度指标或血液pH值指标；以及
电子控制装置，其可操作地与所述传感器装置和所述浓缩液流量控制元件通信连接；
其中该电子控制装置设置为通过该浓缩液流量控制元件根据从所述传感器装置获得的数据来调节浓缩溶液进入液体源的速度。
2.如权利要求1所述的系统，其中所述第一传感器装置设置为监测进入中间装置之前的血液。
3.如权利要求2所述的系统，其还包括一第二传感器装置，该设置为监测一血液电解质浓度或血液pH值的指标，该第二传感器装置设置为监测流出中间装置之后的血液。
4.如权利要求3所述的系统，其中所述电子控制装置可操作地与第二传感器装置连接，并设置为：对比从第一传感器装置和第二传感器装置获得的数据，其中所述电子控制装置设置为：根据从第一传感器装置和第二传感器装置获得的数据的比较结果，来调节浓缩溶液进入液体源的速度。
5.如权利要求1所述的系统，其中所述第一传感器装置设置为：在从血液中清除的液体流出中间装置后，监测从血液中清除的液体中的指标。
6.如权利要求5所述的系统，其中所述电子控制装置设置为：根据从第一传感器装置获得的数据得到血液pH值或血液电解质浓度。
7.如权利要求5所述的系统，还包括一第二传感器装置，该第二传感器装置设置为：在透析液进入中间装置之前，监测液体源中的透析液的指标，其中所述电子控制装置与所述第二传感器装置通信连接，并且设置为：对比从第一传感器和第二传感器获得的数据，其中所述电子控制装置设置为：根据从第一传感器和第二传感器获得的数据的对比结果，来调节浓缩溶液进入液体源的速度。
8.如权利要求1所述的系统，其中所述第一传感器装置设置为：在血液流出中间装置后以及置换液加入到血液之前，监测血液中的指标。
9.如权利要求8所述的系统，其还包括一第二传感器装置，其设置为：在置换液加入到血液中后，监测血液中的指标。
10.如权利要求1所述的系统，其中所述电子控制装置或电子控制装置的部件容置于所述血液液体清除装置的一壳体内。
11.如权利要求1所述的系统，其还包括一计算机可读介质，该计算机可读介质使电子控制装置根据从传感器装置获得的数据来控制浓缩液流量控制元件，以调节浓缩溶液进入液体源的速度。
12.一种血液液体清除系统，其包括：
一中间装置的壳体，其限定一主腔；
一血流清除膜，设置在该壳体中，密封地将主腔分成第一和第二腔体；
一第一入口和一第一出口，与第一腔体液体连通，其中所述系统设置为使血液从第一入口进入第一腔体，并且从第一出口流出第一腔体；
一第二入口和一第二出口，与第二腔体液体连通，其中所述系统设置为使透析液从第二入口进入第二腔体，并且从第二出口流出第二腔体；
一透析液再生中间装置，与一透析液流动路径液体连通，并且设置在透析液流动路径上位于第二入口和第二出口之间；
一浓缩液源，用于容纳一包括浓缩电解质或pH缓冲液的浓缩溶液；
一浓缩液流量控制元件，用于控制浓缩溶液进入透析液再生中间装置下游和第二入口上游之间的透析液流动路径的速度；
一传感器装置，设置为用于监测一指标，该指标是关于透析液再生中间装置下游和第二入口上游之间的透析液流动路径中的透析液的电解质浓度或pH值的；以及
电子控制装置，可操作地与所述传感器装置和浓缩液流量控制元件通信连接，其中所述电子控制装置设置为，根据从所述传感器装置获得的数据，通过所述浓缩液流量控制元件来调节浓缩溶液进入透析液流动路径的速度。
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