The present invention relates to a blood collection apparatus which collects blood from a finger of a subject (blood collection subject).
It is important to have regular medical checkups in order to live a healthy life. One of tests commonly and frequently performed in medical checkups is a blood test for diagnosing states of tissues and organs of the whole body by collecting blood from a subject and analyzing components of the blood. A general blood test is often performed in a medical institution, but is often performed at home as a self-test with a limited measurement item such as a blood glucose level.
A blood collection method that is often performed as blood collection for a self-test, such as blood glucose level measurement, is capillary blood collection. The capillary blood collection is a method of pressing a dedicated skin puncture tool against a finger of a subject to puncture a capillary of the finger and collecting blood that flows out. The capillary blood collection is a simpler blood collection method than venous blood collection. However, the amount of blood that can be secured is small, and thus, complicated work such as compressing and squeezing the finger during blood collection is required to secure the blood collection amount.
PTL 1 discloses a blood collection apparatus that automates blood collection from a finger. The blood collection apparatus includes: a cartridge that holds a puncture tool, a blood collection tube, and an adhesive bandage; a driving mechanism for changing a position of the cartridge and performing an operation of pressing the puncture tool, a container, and a seal against a finger tip; a fixing mechanism for fixing a part of the finger tip; and a compression mechanism for compressing a root of the finger, and pierces the finger tip of a subject with the puncture tool after compressing the root of the finger, collects blood from a puncture wound into the blood collection tube, and the compression is released, and then staunches bleeding from the puncture wound with the adhesive bandage.
PTL 1: JP 2017-225519 A
The blood collection apparatus described in PTL 1 is advantageous in that the blood collection subject can perform blood collection from the finger tip without complicated work. However, there is an individual difference in the diathesis of the blood collection subject according to studies of the present inventors, and there is a possibility that it is difficult to perform stable blood collection and a sufficient blood collection amount is hardly secured even in the blood collection apparatus described in PTL 1.
An object of the present invention is to provide a blood collection apparatus with which blood can be stably collected from a finger tip of any subject while ensuring safety and ease.
In order to achieve the above object, a blood collection apparatus of the present invention has a configuration described in the claims. For example, the blood collection apparatus is provided with: a puncture site holding mechanism for holding a puncture site of a subject; a compression mechanism for performing an operation of compressing and releasing the puncture site when blood is collected from the puncture site; a container holding mechanism for holding a container for collecting blood flowing from a puncture wound at the puncture site; and a driving mechanism for varying the relative distance between the puncture site and the container by vertically moving the puncture site holding mechanism, the container holding mechanism, or the container held by the container holding mechanism when blood flowing from the puncture wound is collected.
According to the blood collection apparatus of the present invention, it is possible to stably collect the blood from the finger tip of any subject while ensuring the safety and ease.
Other objects, configurations, and effects which have not been described above become apparent from embodiments to be described hereinafter.
Hereinafter, an embodiment of the present invention will be described with reference to the drawings. Note that embodiments to be described later are merely examples, and it goes without saying that other modes obtained by combination of the respective embodiments and combination or replacement with a known or well-known technique are also possible.
In addition, the description of the claims is given with a single claim in order to simplify the citation relationship, but the present invention also includes a case where a multi-claim is used and a case where a multi-multi claim is used.
First, circumstances leading to the present invention will be described.
Since blood collection from a subject is essential to perform a blood test, it is preferable that anyone can easily and safely collect blood. Therefore, the present inventors have studied various automatic blood collection methods and systems, and have proposed a blood collection apparatus described in PTL 1. With the blood collection apparatus described in PTL 1, anyone can easily and safely collect blood. According to the studies of the present inventors, however, it has been found that blood is coagulated in a puncture wound and it becomes difficult to perform stable blood collection, for example, when the amount of blood flowing out from the puncture wound is small and a state in which the blood remains on a finger tip is prolonged even if compression and release are repeated depending on the diathesis of a subject or the like. Therefore, a blood collection apparatus having a function of actively promoting bleeding from a finger tip is required in order to constantly realize stable blood collection for any subject. As a result of various studies, the present inventors have found that the blood remaining on the finger tip when the blood collection tube is separated from the finger tip is separated from the finger tip to promote movement of the blood toward the blood collection tube by repeatedly changing a relative distance between the blood collection tube and the finger tip in addition to compression and release of a finger so that the blood coagulation at the puncture wound is suppressed. Since the blood coagulation at the puncture wound is suppressed, the stable blood collection can be realized by repeating the compression and release of the finger.
Next, a basic configuration of a blood collection apparatus 1 according to the embodiment of the present invention will be described with reference to
The driving mechanism 12 includes a rotational-direction driving mechanism 120 and a vertical-direction driving mechanism 121. The rotational-direction driving mechanism 120 rotates the cartridge 11 in a cartridge container 101 (with a z-axis as a rotation axis) through a cartridge holder 122 in which the cartridge 11 is set, and rotationally moves the cartridge 11 such that the puncture tool 1111, the blood-count blood collection tube 1121, the biochemical and immunological blood collection tube 1131, the gauze 1141, or the adhesive bandage (seal) 1151 is arranged immediately below a blood collection window 1311 of a finger placement portion 131 on which a finger to be subjected to blood collection is placed. The rotational-direction driving mechanism 120 also serves as a horizontal-direction driving mechanism for changing a relative position between the blood collection window 1311 of the finger placement portion 131, and the puncture tool, the blood collection tube, the gauze, or the adhesive bandage on a horizontal plane. The vertical-direction driving mechanism 121 includes a push rod 1211, and moves the puncture tool 1111, the blood-count blood collection tube 1121, the biochemical and immunological blood collection tube 1131, the gauze 1141, or the adhesive bandage 1151 arranged immediately below the blood collection window 1311 in the vertical direction (z direction) through the push rod 1211 to be brought close to or be pressed against a finger. The puncture tool 1111 is pressed against a finger to puncture a finger 153, the blood-count blood collection tube 1121 or the biochemical and immunological blood collection tube 1131 is brought close to the finger to collect blood from a puncture point without scattering the blood to the surroundings, the gauze 1141 is pressed against the finger to wipe off excess blood, and the adhesive bandage 1151 is pressed against the finger so that bleeding from the puncture point can be staunched. As a power source of the driving mechanism 12, a mechanical power source, such as a spring, may be used in addition to electrical energy such as an external power source and a built-in battery. When the spring is used as the power source, the use in an area where supply of electricity is difficult becomes possible.
The cuff mechanism finger fixing unit 13 includes the cuff mechanism 130 provided with a cuff configured to tighten a blood collection target finger and the finger placement portion 131 configured to place a blood collection target finger tip. The finger placement portion 131 further includes a disposable finger placement plate component 1312 at a point to be in contact with the finger. The finger placement plate component includes the blood collection window 1311 which is a void for blood collection.
The pressure adjustment mechanism 17 includes a cuff internal pressure sensor 171 configured to measure the internal pressure of the cuff of the cuff mechanism 130, and a cuff valve 172 and a cuff pump 173 configured to control the internal pressure of the cuff, and can adjust the tightening pressure of the blood collection target finger by controlling the internal pressure of the cuff.
Note that the cuff mechanism finger fixing unit 13 is a configuration example of a puncture site holding mechanism. The cuff mechanism 130 and the pressure adjustment mechanism 17 are configuration examples of a compression mechanism for performing an operation of compressing and releasing a puncture site at the time of collecting blood from the puncture site. The cartridge 11 is a configuration example of a container holding mechanism for holding a container for collecting blood flowing from a puncture wound of the puncture site. The driving mechanism 12 is a configuration example of a driving mechanism for varying the relative distance between the puncture site and the container by vertically moving the puncture site holding mechanism, the container holding mechanism, or the container held by the container holding mechanism when blood flowing from the puncture wound is collected.
Next, a configuration of the cartridge 11 used by the blood collection apparatus 1 according to the embodiment of the present invention will be described with reference to
The cartridge 11 holds a puncture tool holder 111 that holds the puncture tool 1111, a blood-count blood collection tube holder 112 that holds the blood-count blood collection tube 1121, a blood collection tube holder 113 that holds the biochemical and immunological blood collection tube 1131 that holds the biochemical and immunological blood collection tube 1131, a gauze holder 114 that holds the gauze 1141, and an adhesive bandage holder 115 that holds the adhesive bandage 1151 in a puncture tool holder holding hole 1112, a blood-count blood collection tube holder holding hole 1122, a biochemical and immunological blood collection tube holder holding hole 1132, a gauze holder holding hole (which is hidden by the blood-count blood collection tube holder 112 and thus is not illustrated), and an adhesive bandage holder holding hole 1152 in a cartridge case 110. Centers of the respective holding holes are located on a circumference of a circle about the rotation axis of the cartridge 11. In addition, each of the holding holes is a through hole, but the puncture tool holder 111, the blood-count blood collection tube holder 112, the biochemical and immunological blood collection tube holder 113, the gauze holder 114, and the adhesive bandage holder 115 do not fall from the respective holding holes since a part of each of the puncture tool holder 111, the blood-count blood collection tube holder 112, the biochemical and immunological blood collection tube holder 113, the gauze holder 114, and the adhesive bandage holder 115 is larger than each of the holding holes.
Note that the plurality of blood collection tubes are held in the cartridge 11 in the present embodiment, so that it is possible to collect blood for different purposes of tests by one-time blood collection. In addition, the present embodiment is configured such that the plurality of blood collection tubes of the cartridge 11 can be held on the circumference of the circle about the rotation axis of the cartridge 11, and the plurality of blood collection tubes are arranged at substantially point-symmetric positions about the rotation axis. Thus, for example, there is an effect that another blood collection tube into which blood collection has been completed can be detached during blood collection into one blood collection tube although details will be described later. It is desirable to detach a blood collection tube after blood collection and stir the blood collection tube quickly by inversion and mixing, and thus, it is advantageous that another blood collection tube into which blood collection has been completed can be detached during blood collection into one blood collection tube. These are features that can also be applied to the blood collection apparatus described in PTL 1.
The puncture tool 1111 is a single-use skin puncture tool including a puncture needle and a holder incorporating the puncture needle. When a tip of the puncture tool 1111 is pressed against a finger, the puncture needle protrudes at the moment and punctures a skin and capillary blood vessels of the finger. The blood-count blood collection tube 113 and the biochemical and immunological blood collection tube 114 are containers for collecting blood, and collect blood flowing from a pierced point by pressing mouths of the blood collection tubes against the pierced point of the finger. The blood-count blood collection tube 1121 is a blood collection tube whose inner surface is coated with an anticoagulant, and has an effect of suppressing a coagulation reaction of blood after blood collection. The biochemical and immunological blood collection tube 1131 is a blood collection tube incorporating a separation agent, and can separate blood cells and serum based on a difference in specific gravity by applying a centrifugal force after blood collection. The gauze 1141 is a water-absorbent cloth, and is pressed against the finger to wipe off excess blood from the pierced point of the finger. The adhesive bandage 116 is provided with an absorbent pad at a center of an adhesive sheet, and covers the pierced point of the finger. When being set in the adhesive bandage holder 115, the adhesive bandage 116 is attached with an adhesive surface facing upward.
(1) Operation Check Process
(a) First, when the apparatus is powered on, the rotational-direction driving mechanism 120 (
(b) The cartridge 11 is set in the cartridge holder 122 inside the cartridge container 101. After setting the cartridge 11, the processing transitions to cartridge check.
(c) It is checked whether the rotational-direction driving mechanism 120 (
(d) The user of the apparatus inputs the ID of a blood collection subject using the input/output device. Blood collection conditions differ for individual blood collection subjects, and the blood collection condition is input using the input/output device in a case where the blood collection condition of the blood collection subject is not recorded in a memory of the apparatus or in a case of changing the blood collection condition. The blood collection conditions in the present embodiment are set as follows. After the input is finished, the processing transitions to the finger setting process.
(i) Types of Blood Collection Tube
Blood-count blood collection tube and biochemical and immunological blood collection tube.
(ii) Conditions at the Time of Puncture
Compression time by the cuff before and after puncture: Tbefore-puncture, Tafter-puncture,
Cuff pressure at that time: Ppuncture
(iii) Conditions at the Time of Blood Collection
The number of repetitions of compression and release of the cuff at time of blood collection in the blood-count blood collection tube: N1,
Standby time before cuff compression: T1before-cuff,
Cuff compression time: T1during-cuff,
Cuff release time: T1after-cuff,
Cuff pressure: P1cuff-pressure
The number of repetitions of compression and release of the cuff at the time of blood collection in the biochemical and immunological blood collection tube: N2,
Standby time before cuff compression: T2before-cuff,
Cuff compression time: T2during-cuff,
Cuff release time: T2after-cuff,
Cuff pressure: P2cuff-pressure
(2) Finger Setting Process
(a)
(b) After the setting of the finger tip is completed, the cuff mechanism fixing unit 13 is pushed in a direction of an arrow in the drawing as illustrated in
After the finger setting process is completed, the operator gives an instruction to start via the input/output device, so that the blood collection apparatus 1 transitions to the puncture process.
(3) Puncture Process
(a)
(b) First, the internal pressure of the cuff is increased by the pressure adjustment mechanism (not illustrated), the finger tip of the middle finger 153 as the blood collection target is compressed so that blood is collected on the finger tip. Note that more blood can be collected on the finger tip by compressing a range from the first joint of the finger where the capillary vessels are densely packed to the finger tip than by compressing a range from the first joint to the root of the finger, and thus, such a range is suitable as a compressing range.
(c) In parallel with the compression with the cuff, the rotational-direction driving mechanism 120 (
After the puncture process is completed, the processing transitions to the blood collection process.
(4) Blood Collection Process
(a) The blood collection process is divided into a blood collection process collecting two (blood count and biochemical and immunological) blood collection tubes and a blood collection process collecting one (blood count or biochemical and immunological) blood collection tube depending on the conditions of the blood tube pipe input in the operation check process. In the present embodiment, a case where the collection of two blood collection tubes will be described.
The cartridge 11 is rotated by the rotational-direction driving mechanism 120 (
(b) A method of compressing a finger tip and a method of operating a blood collection tube having an effect of increasing the blood collection amount will be described with reference to
The internal pressure of the cuff changes at a cycle of 7.5 sec. including 5 sec. (at the time of compression) of 90 kPa and 2.5 sec. (at the time of release) of 0 kPa. Meanwhile, the blood collection tube also changes in the vertical movement of 5 mm at a cycle of 7 sec. The pressure here is a differential pressure from atmospheric pressure.
Although there is little blood flowing from the finger tip immediately after the finger tip is compressed (at a time point of 0 sec.), the blood is collected on the finger tip by compressing the finger tip with the cuff, and the blood flowing from the puncture point forms a droplet on the finger tip (at a time point of 2 sec.). As the compression with the cuff is continued, the droplet of the blood becomes larger.
Immediately before the end of the cuff compression, the mouth of the blood-count blood collection tube 1121 is brought close to the finger tip, and the droplet of blood is brought into contact with the blood-count blood collection tube 1121 (at a time point of 4.5 sec.). As a result of the contact, a part of the droplet of blood drops on a bottom of the blood-count blood collection tube 1121, and a part of the blood remains between the finger tip and the mouth of the blood-count blood collection tube 1121.
After the contact, the finger tip is released from the compression by adjusting the internal pressure of the cuff to 0 kPa. This operation opens a blood vessel of the tightened finger, so that blood flows to the finger tip again. Subsequently, the mouth of the blood-count blood collection tube 1121 is separated from the finger tip. With this operation, the blood accumulated between the finger tip and the mouth of the blood-count blood collection tube 1121 can be separated toward the mouth of the blood-count blood collection tube 1121 (at a time point of 7 sec.). The separated blood moves toward the bottom of the blood-count blood collection tube 1121 by gravity. In this manner, blood is collected in the blood-count blood collection tube 1121 by repeating the compression and release of the cuff and the change of the relative distance between the finger tip and the blood-count blood collection tube 1121.
Since the compression and release with the cuff are repeated, it is possible to repeat promotion of bleeding from the finger tip and replenishment of blood to the finger tip. In addition, in a case where it is difficult to change the distance between the blood-count blood collection tube 1121 and the finger tip, the coagulation reaction proceeds in the blood accumulated between the finger tip and the mouth of the blood-count blood collection tube 1121 so that bleeding from the puncture point is delayed. However, the coagulation reaction at the puncture point can be suppressed by changing the distance between the blood-count blood collection tube 1121 and the finger tip and removing the blood accumulated between the finger tip and the mouth of the blood-count blood collection tube 1121 at regular time intervals as in the present embodiment. As a result, the effect of increasing the blood collection amount can be obtained by repeating the compression and release with the cuff and the change of the distance between the blood-count blood collection tube 1121 and the finger tip. In the present embodiment, the compression and release of the cuff is performed at the cycle of 7.5 sec. including 5 sec. and 2.5 sec., and the vertical movement of the blood-count blood collection tube 1121 is also performed at the cycle of 7.5 sec. with the amplitude of 5 mm. However, it is preferable to change these conditions depending on a state of a blood collection subject. These conditions are determined based on results of blood collection from subjects in various states. For example, in a case of a subject with thick fingers, conditions are generally set with a shorter cycle than that of a subject with thin fingers. Further, the relative distance between the finger tip and the blood-count blood collection tube 1121 is changed by moving the blood-count blood collection tube 1121 in the present embodiment, but a similar effect can be expected even if the relative distance between the finger tip and the blood-count blood collection tube 1121 is changed by fixing the blood-count blood collection tube 1121 and moving the finger tip. In addition, a similar effect can be expected even if the cartridge itself is vertically moved to change the relative distance between the finger tip and the blood-count blood collection tube 1121. In addition, it is preferable that a repetition timing of the compression and release of the finger tip with the cuff and a repetition timing of the change of the relative distance between the finger tip and the blood-count blood collection tube 1121 be set such that the blood-count blood collection tube 1121 is brought close to the finger tip immediately before the end of the compression of the cuff and the blood-count blood collection tube 1121 is separated from the finger tip after the release of the cuff as illustrated in
(c) The blood collection amount in the blood-count blood collection tube 1121 is measured by the camera 142 for blood collection amount confirmation (
(d) The cartridge 11 is rotated by the rotational-direction driving mechanism 120 (
(e) In addition, the blood-count blood collection tube 1121 into which blood collection has been completed is detached and subjected to inversion and mixing during blood collection into the biochemical and immunological blood collection tube 1131 since the coagulation reaction proceeds in the blood collected by the blood-count blood collection tube 1121. Through the inversion and mixing, the anticoagulant attached to the inner surface of the blood-count blood collection tube 1121 is mixed with the blood so that the coagulation reaction is suppressed.
After the blood collection into the biochemical and immunological blood collection tube 1131 is completed, the processing transitions to the hemostasis process.
(5) Hemostasis Process
(a) The cartridge 11 is rotated by the rotational-direction driving mechanism 120 (
(b) Thereafter, the cartridge 11 is rotated to move the adhesive bandage 1151 directly below the blood collection window 1311. Subsequently, the adhesive bandage 1151 is pushed up toward the finger tip of the middle finger 153 by the vertical-direction driving mechanism 121, and the adhesive bandage 1151 is pasted to the finger tip of the middle finger 153 to cover the puncture point of the finger tip.
Since the blood remaining on the finger tip is wiped off with the gauze 1141 before covering the puncture point with the adhesive bandage 1151, it is possible to prevent the blood from overflowing from the adhesive bandage 1151 and reliably paste the adhesive bandage 1151 to the finger tip.
(c) After the adhesive bandage 1151 is pasted, the blood collection subject takes off the middle finger 153 from the cuff mechanism. Thereafter, the biochemical and immunological blood collection tube 1131 is detached by a similar method as that of the blood-count blood collection tube 1121.
According to the above procedure using the blood collection apparatus 1, the blood is collected into the blood-count blood collection tube 1121 and the biochemical and immunological blood collection tube 1131. Although the blood is collected into the two blood collection tubes (the blood-count blood collection tube and the biochemical and immunological blood collection tube) in the present embodiment, only the blood collection into the blood-count blood collection tube 1121 or only the blood collection into the biochemical and immunological blood collection tube 1131 can be also performed according to procedures illustrated in
Next, a preferable movement method of the cartridge 11 in blood collection, a preferable shape of a blood collection tube, a method of covering a blood collection tube after blood collection with a lid and stirring the blood collection tube, and a method of performing only the blood collection process will be described.
First, the preferable movement method of the cartridge 11 will be described. In the blood collection by the blood collection apparatus of the present embodiment, there is a possibility that blood may drop from the finger tip after puncture. Therefore, it is preferable to rotate the cartridge 11 so as not to pass over components (the biochemical and immunological blood collection tube 1131, the gauze 1141, and the adhesive bandage 1151) to be used in subsequent steps. Therefore, in the case of using the cartridge 11 of
According to the present embodiment, since the blood collection apparatus using the blood collection tube, a finger compression and release mechanism, and a vertical-direction movement mechanism of the blood collection tube is provided, an extremely excellent effect that stable blood collection can be constantly realized for any subject is exhibited.
Next, the preferable shape of the blood collection tube will be described. The blood collection in the present embodiment is characterized in that the droplet of blood is transferred from the finger tip to the blood collection tube by changing the relative distance between the finger tip and the blood collection tube. Therefore, it is desirable that the blood collection tube have performance of attracting blood that is in contact.
Next, automation of covering a blood collection tube after blood collection with a lid and stirring will be described. Although the blood collection tube after blood collection is detached and stirred by inversion and mixing in the above-described embodiment, the blood collection tube can be automatically covered with the lid and stirred in the apparatus by adding the following mechanism in the apparatus.
Although all the steps of puncture, blood collection, and hemostasis are performed using the blood collection apparatus 1 in the present embodiment, one of features of the present invention is the increase in the blood collection amount during the blood collection. Therefore, the puncture and hemostasis may be performed manually.
In such a case, a finger is punctured with a commercially available puncture tool, and then, the finger is set in the blood collection apparatus 1 in which the cartridge 11 attached with only a holder for holding a blood collection tube is set in advance. Thereafter, only the above-described blood collection process is performed, and then, the finger is taken off from the blood collection apparatus 1 to manually perform hemostasis. It can be expected to obtain a larger blood collection amount by using the blood collection apparatus of the present embodiment as compared with a case where blood collection is manually performed.
Number | Date | Country | Kind |
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2019-133951 | Jul 2019 | JP | national |
Filing Document | Filing Date | Country | Kind |
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PCT/JP2020/021793 | 6/2/2020 | WO |