本文關(guān)鍵詞： 車禍 院前出診 空間分布 聚類探測(cè)　出處：《山西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：院前急救是對(duì)傷患的轉(zhuǎn)運(yùn)和傷患到達(dá)指定醫(yī)院前的醫(yī)療救護(hù),是現(xiàn)代醫(yī)療服務(wù)體系的重要組成部分,體現(xiàn)了一個(gè)國家或地區(qū)醫(yī)療服務(wù)體系是否完整、是否具備處理突發(fā)事件的應(yīng)急能力。目前,我國相關(guān)的研究?jī)?nèi)容主要集中在施救措施和院前管理模式上,而院前出診的具體特征及內(nèi)在成因研究較少。本文旨在參考國外院前出診急救資源的時(shí)空分布研究的經(jīng)驗(yàn),懫用空間分析與可視化技術(shù),基于空間自相關(guān)和點(diǎn)要素層次聚類分析等方法,針對(duì)太原市6城區(qū)因車禍的院前出診情況,研究車禍院前出診的空間聚集特征和分析的技術(shù)流程,并通過時(shí)空掃描研究車禍院前出診的負(fù)荷,研究成果為車禍院前出診大數(shù)據(jù)分析策略提供了參考,對(duì)研究太原市車禍院前急救出診的空間規(guī)律有效性、及時(shí)協(xié)同派診有著現(xiàn)實(shí)的意義。本課題主要進(jìn)行了以下三方面的研究:1、基于面域的車禍出診空間聚集特征分析;2、基于點(diǎn)域的車禍出診空間分布特征分析3、基于面域的出診負(fù)載時(shí)空分布特征分析。研究結(jié)果如下:1、以街道/鄉(xiāng)鎮(zhèn)(面域)為單位進(jìn)行車禍院前出診的空間分布、聚集性特征及可視化研究。其中,Global Moran`s I值為0.191224、P0.01,顯示太原市車禍出診地點(diǎn)并非隨機(jī)分布,有一定的空間聚集性;通過LISA分析顯示,太原市城區(qū)車禍出診頻次高-高聚集街道/鄉(xiāng)鎮(zhèn)(H-H聚集區(qū)),主要集中在平陽路街道、太原高新技術(shù)產(chǎn)業(yè)開發(fā)區(qū)、營盤街道、塢城路街道、黃陵街道、金勝鎮(zhèn),結(jié)合2016年度的城建規(guī)劃,了解到這些地區(qū)常為城鄉(xiāng)結(jié)合部和城建熱點(diǎn)區(qū),它們之間可能存在關(guān)聯(lián),需要我們進(jìn)一步的研究。從目前的資料看,市城區(qū)尚未發(fā)現(xiàn)有統(tǒng)計(jì)學(xué)意義的低-低(L-L)聚集區(qū)。2、以院前車禍出診點(diǎn)的地理坐標(biāo)(點(diǎn)域)為單位,通過核密度估算和層次聚類兩種方法結(jié)合的可視化表達(dá)。結(jié)果顯示:小店區(qū)康寧街附近、萬柏林區(qū)南寒附近、萬柏林區(qū)迎澤西大街和平路口附近、尖草坪區(qū)解放北路上段附近、鋼園路上段附近、小店區(qū)南中環(huán)橋東近平陽路附近和尖草坪區(qū)勝利橋東臨大同路附近,共6個(gè)高發(fā)區(qū)域和5.5公里的區(qū)域協(xié)同出診半徑。其結(jié)果既可分層級(jí)表達(dá),又體現(xiàn)了車禍出診的精確集聚區(qū)域,體現(xiàn)出點(diǎn)中帶面的特征。3、將出診時(shí)間與空間數(shù)據(jù)結(jié)合,使用SatScan時(shí)空掃描并進(jìn)行可視化表達(dá),研究聚集區(qū)域和“出診負(fù)荷”。結(jié)果顯示:2016/11/3到2016/11/9間存在一個(gè)主要聚集區(qū),其中包括5個(gè)街道/鄉(xiāng)鎮(zhèn);2016/11/1到2016/11/4間存在一個(gè)次要聚集區(qū),包括4個(gè)街道/鄉(xiāng)鎮(zhèn)。聚集區(qū)域內(nèi)出診強(qiáng)度均為掃描區(qū)域外的3倍以上,但其“出診負(fù)荷”分別為0.38、0.52,均小于1,車禍聚類區(qū)域的院前出診對(duì)同期其他原因的院前出診影響較小,表明院前急救資源仍有一定儲(chǔ)備。綜上所述:1、太原市6城區(qū)因車禍的院前出診具有空間聚集性;其中城鄉(xiāng)結(jié)合部和城建熱點(diǎn)區(qū)的6個(gè)街道/鄉(xiāng)鎮(zhèn)呈現(xiàn)高-高聚集,尚未發(fā)現(xiàn)有統(tǒng)計(jì)學(xué)意義的低-低(LL)聚集區(qū)。2、點(diǎn)域研究的6個(gè)高發(fā)區(qū)域其區(qū)域協(xié)同出診半徑為5.5公里。3、時(shí)空掃描的一個(gè)主聚集區(qū)域和一個(gè)次要聚集區(qū)內(nèi),其區(qū)域內(nèi)RR是掃描區(qū)域外的3倍以上,但其“出診負(fù)荷”均小于1,對(duì)同期其他原因的院前出診影響較小,說明院前急救資源就此方面而言仍有一定儲(chǔ)備。
[Abstract]:Pre hospital emergency injuries is to transport wounded and arrived at the designated medical hospital, is an important part of modern medical service system, medical service system reflects a country or region is complete, whether they have the ability of emergency handling emergencies. At present, the related research contents in China are mainly concentrated in the rescue measures and pre hospital management mode, and the specific characteristics of pre hospital visits and internal causes of less. The purpose of this paper is to refer to the foreign pre hospital emergency visits resources study on temporal and spatial distribution of experience, Zhi spatial analysis and visualization, spatial elements and hierarchical clustering analysis method based on, for the city of Taiyuan city because of 6 the accident before hospital visits, technical features and process analysis of the accident before the hospital visits gathering space, and through the research on the spatial scanning of pre hospital visits accident load, research results for Big data analysis provides a reference strategy of pre hospital emergency visits accident, space law validity visits in the study of Taiyuan city traffic accident before hospital, timely coordination is of great realistic significance to send diagnosis. This thesis mainly focuses on the following three aspects: 1, the region's spatial aggregation characteristics based on the analysis of the accident at 2 points; domain accident analysis on spatial distribution characteristics based on 3 visits, visits the area load analysis of spatial and temporal distribution features. Based on the research results are as follows: 1, to street / township (area) the distribution of space for the unit before visits the accident hospital, the characteristics of aggregation and visualization research. Among them, Global Moran`s I 0.191224, P0.01 Taiyuan City, traffic accident visits location not randomly distributed, there is a certain space aggregation; through the LISA analysis showed that the accident in Taiyuan city visits high frequency high street / town aggregation (H-H zone), mainly concentrated in the Pingyang Road Street Camp Street, Taiyuan hi tech Industrial Development Zone, Wu Cheng Road Street, Huangling street, Jin Sheng Zhen, with 2016 annual urban construction planning, to understand these areas often for the integration of urban and rural and urban hot zone, there may be an association between them, we need further study. From the current data, City has not yet found a statistically significant low low (L-L) gathering area.2, pre hospital visits to the accident geographic coordinates points (point domain) as a unit, visual expression through the combination of kernel density estimation and hierarchical clustering of two methods. The results showed that near the Corelle Street Xiaodian District, Berlin District South near 10000, near million Berlin District Yingze West Street near the intersection of peace, Liberation North Road near the upper Jiancaoping District, near the upper steel road, east south central district near Pingyang road and Jiancaoping District shenglidong Lin Datong Road nearby, a total of 6 high-risk areas and 5.5 male In the regional collaborative visits radius. The result not only can be layered level expression, but also reflects the accurate agglomeration of regional accident reflects the features of a home visit, with.3 points, will call time and space data with the use of SatScan, spatial scanning and visual expression, research on aggregation region and "house load". The results showed: 2016/11/3 to 2016/11/9 is one of the main gathering area, including 5 Street / township; 2016/11/1 to 2016/11/4 between a secondary gathering area, including 4 Street / township. Visits gathered in the region outside the region scanning intensity were more than 3 times, but the "house load" were 0.38,0.52, were less than 1, the accident of pre hospital visits to the clustering region over the same period of other causes of pre hospital visits showed less influence of pre hospital emergency resources still has certain reserves. To sum up: 1, 6 Taiyuan city hospital for diagnosis before the accident with space Aggregation; the combination of urban and rural and Urban Construction Department of 6 street / hot area township showing high high aggregation, has not yet found a statistically significant low low (LL) gathering area.2, 6 high-risk areas of the regional collaboration domain visits a radius of 5.5 km.3, spatial scanning of a main gathering area and a secondary gathering area, the area is RR scanning outside the region more than 3 times, but the "house load" was less than 1 in the same period, other causes of pre hospital visits has little influence, that of first aid resources in this respect there is still a certain reserve.

【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R459.7

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