本文關(guān)鍵詞：戰(zhàn)時傷病員醫(yī)療后送及衛(wèi)生裝備配置仿真研究　出處：《中國人民解放軍軍事醫(yī)學科學院》2012年博士論文　論文類型：學位論文

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【摘要】：當前，軍事思想、編制體制、作戰(zhàn)行動和保障方式有了很大變化，對衛(wèi)勤保障能力提出了新的要求。信息化條件下衛(wèi)勤保障的基本特征是一體化的聯(lián)勤保障和靈活機動的衛(wèi)勤戰(zhàn)術(shù)，衛(wèi)勤力量要實現(xiàn)更好的機動性和更快的反應(yīng)，這對衛(wèi)生裝備的優(yōu)化配置提出了更高的要求。合理優(yōu)化配置衛(wèi)生裝備，對于提高戰(zhàn)時傷病員的治愈歸隊率，降低傷死率、病死率和殘疾率，進而維護和提高整個部隊的戰(zhàn)斗力具有重要的意義。戰(zhàn)時傷病員醫(yī)療后送及衛(wèi)生裝備配置問題，涉及眾多的動態(tài)性和隨機性因素問題，屬于復雜的動態(tài)隨機系統(tǒng)問題。而傳統(tǒng)的解析方法通常用于處理靜態(tài)的、規(guī)范的、簡單幾率性的問題，在處理復雜問題時，往往需要做出很強的簡化假設(shè)，這影響了模型的有效性。與之相比，仿真方法可以比較真實地描述動態(tài)隨機系統(tǒng)的運行、演變及其發(fā)展過程。因此本課題采用系統(tǒng)仿真技術(shù)對這一問題開展研究。 本課題以醫(yī)療后送理論和系統(tǒng)仿真技術(shù)為基礎(chǔ)，劃分救治機構(gòu)的模塊和各救治模塊的救治工作序列，為仿真研究提供數(shù)量化框架與依據(jù)；實現(xiàn)傷病員救治過程和生存過程的數(shù)量化，為仿真研究提供基礎(chǔ)數(shù)據(jù)支撐；分析和構(gòu)建傷病員醫(yī)療后送數(shù)學模型，分析模擬方法，為仿真研究提供運行邏輯支撐；以Simio仿真平臺為基礎(chǔ)，開發(fā)三維可視化仿真系統(tǒng)，為仿真研究提供工具；最后利用仿真系統(tǒng)構(gòu)建仿真模型，結(jié)合仿真實驗，實現(xiàn)衛(wèi)生裝備的優(yōu)化配置研究。下面是課題研究的具體內(nèi)容： （1）救治機構(gòu)模塊分組和救治工作序列研究。根據(jù)時效救治與現(xiàn)代分級救治理論，闡述救治機構(gòu)戰(zhàn)傷救治的分級管理，以某典型救治機構(gòu)為例分析其勤務(wù)功能；結(jié)合模塊化理論和方法，分析戰(zhàn)時傷病員救治鏈的模塊構(gòu)成，區(qū)分救治機構(gòu)的救治模塊。在上述工作基礎(chǔ)上，根據(jù)救治機構(gòu)的救治范圍、救治技術(shù)措施和救治工作流程，構(gòu)建救治模塊的救治工作序列，為仿真研究提供數(shù)量化框架和依據(jù)，為仿真系統(tǒng)運行提供結(jié)構(gòu)支撐。 （2）傷病員醫(yī)療后送及衛(wèi)生裝備配置仿真基礎(chǔ)數(shù)據(jù)研究。參考美軍傷情碼，結(jié)合專家咨詢，形成本課題傷病員分類方法；針對具體作戰(zhàn)情景，獲取傷病員構(gòu)成結(jié)構(gòu)；通過專家咨詢，明確傷病員救治優(yōu)先級、生命威脅程度等傷病員救治基礎(chǔ)數(shù)據(jù)。通過對傷病員在各救治階梯傷病情和救治措施的分析，獲取傷病員救治工作序列，實現(xiàn)傷病員救治過程的數(shù)量化研究。通過專家咨詢，獲取我軍戰(zhàn)時傷病員生存概率數(shù)據(jù)，以Weibull生存函數(shù)為基礎(chǔ)，對調(diào)研數(shù)據(jù)進行曲線擬合，構(gòu)建傷病員生存模型，實現(xiàn)傷病員生存過程的數(shù)量化研究。該部分研究為整個仿真研究和仿真系統(tǒng)運行提供基礎(chǔ)數(shù)據(jù)支撐。 （3）傷病員醫(yī)療后送及衛(wèi)生裝備配置仿真概念模型研究。闡述面向?qū)ο蠓抡娼？蚣艿幕緝?nèi)容和方法；根據(jù)救治鏈模塊劃分研究和仿真系統(tǒng)建模功能分析，構(gòu)建傷病員醫(yī)療后送及衛(wèi)生裝備配置仿真系統(tǒng)建模對象的層次結(jié)構(gòu)；通過分析和構(gòu)建傷病員生成、救治和后送模型，提出仿真假設(shè)，分析各部分的模擬方法，實現(xiàn)對仿真系統(tǒng)建模對象行為和交互描述。該部分研究為整個仿真研究和仿真系統(tǒng)提供運行邏輯支撐。 （4）傷病員醫(yī)療后送及衛(wèi)生裝備配置仿真系統(tǒng)開發(fā)。對眾多仿真軟件進行比較，選擇Simio作為開發(fā)平臺，，并闡述其建�？蚣埽贿M行數(shù)據(jù)庫數(shù)據(jù)分析與設(shè)計，利用Access2007構(gòu)建仿真底層數(shù)據(jù)庫，并與仿真系統(tǒng)進行了交互，解決了仿真系統(tǒng)的數(shù)據(jù)輸入問題；分析了三維虛擬仿真實現(xiàn)方法，利用三維建模工具構(gòu)建三維實體庫，結(jié)合Simio的虛擬現(xiàn)實表現(xiàn)能力，解決了仿真系統(tǒng)的三維虛擬表現(xiàn)問題；利用Simio仿真平臺面向?qū)ο蠛投鄬哟谓５膬?yōu)勢，開發(fā)戰(zhàn)時傷病員醫(yī)療后送及衛(wèi)生裝備配置仿真建模所需的一系列智能對象，形成仿真建模對象庫，解決了系統(tǒng)的建模功能實現(xiàn)問題。該部分為仿真系統(tǒng)的開發(fā)部分，為仿真研究提供工具。 （5）進行衛(wèi)生裝備配置仿真模型與仿真實驗研究。分析了基于課題開發(fā)的仿真系統(tǒng)的衛(wèi)生裝備配置仿真研究過程；依據(jù)仿真系統(tǒng)，構(gòu)建某救護所和包含后送對象的某救治鏈衛(wèi)生裝備配置仿真模型，模型的構(gòu)建過程驗證了仿真系統(tǒng)在衛(wèi)生裝備配置仿真建模方面的便捷性和有效性。利用上述仿真模型，對典型的衛(wèi)生裝備配置問題進行仿真實驗研究，為衛(wèi)勤機關(guān)和科研人員提供了衛(wèi)生裝備配置仿真研究方法和決策依據(jù)。該部分是典型的衛(wèi)生裝備配置仿真研究，為仿真系統(tǒng)的應(yīng)用部分，也是仿真研究的案例部分。 本課題研究的創(chuàng)新之處： （1）以救治模塊、救治工作序列、傷病員生存模型研究為基礎(chǔ)，實現(xiàn)了傷病員救治過程和生存過程的數(shù)量化研究，開發(fā)了傷病員醫(yī)療后送仿真底層數(shù)據(jù)庫，為醫(yī)療后送和衛(wèi)生裝備研究領(lǐng)域提供了專業(yè)信息平臺，對衛(wèi)生勤務(wù)與裝備的數(shù)量化研究具有重要的意義。 （2）利用模塊分組研究和仿真系統(tǒng)建模功能分析，劃分了我軍戰(zhàn)時傷病員醫(yī)療后送及衛(wèi)生裝備配置仿真的建模對象，構(gòu)建了相關(guān)對象的層次結(jié)構(gòu)。在此基礎(chǔ)上，構(gòu)建和分析了傷病員生成模型，救治鏈傷病員救治模型、救治機構(gòu)傷病員救治模型、救治模塊傷病員救治模型，以及傷病員后送模型，并分析了各模型的模擬方法，為該領(lǐng)域仿真系統(tǒng)開發(fā)、仿真建模和實驗研究提供了技術(shù)方法。 （3）對Simio仿真平臺進行二次開發(fā)，分別構(gòu)建了仿真底層數(shù)據(jù)庫，解決了以往仿真研究底層數(shù)據(jù)匱乏的問題；開發(fā)了三維實體庫，結(jié)合Simio的虛擬現(xiàn)實表現(xiàn)能力，實現(xiàn)了三維虛擬仿真，解決了以往仿真研究視覺表現(xiàn)差的問題；開發(fā)了建模對象庫，實現(xiàn)了戰(zhàn)時傷病員醫(yī)療后送及衛(wèi)生裝備配置三維可視化仿真系統(tǒng)的開發(fā)與集成，為衛(wèi)勤機關(guān)和科研人員提供了專業(yè)的仿真研究工具，解決了以往仿真研究建模方法繁瑣復雜的問題，也使得決策者可從衛(wèi)勤保障的整體來研究和分析衛(wèi)生裝備的部署、保障、評價以及發(fā)展決策，將進一步提高相關(guān)決策和研究工作的可靠性和科學性。
[Abstract]:At present, military thought, systems, operations and security has greatly changed, puts forward new requirements on the ability of medical support. The basic characteristics of medical support under the condition of informationization is the integration of logistic support and flexible service tactics, service resources to achieve better mobility and faster response, put forward the high demand for medical equipment allocation optimization. Optimization of medical equipment, to improve the cure rate of return in wartime, to reduce the injury death rate, mortality rate and disability rate, and maintenance and has an important significance to improve the whole part of the combat team. In wartime medical evacuation and medical equipment allocation problem. The problem relates to the dynamic and random factors, which belongs to the dynamic random complex system. But the traditional analysis method is commonly used to handle static, standardized, simple probability of Problems in dealing with complex problems, often need to make strong simplifying assumptions, which affect the effectiveness of the model. Compared with the simulation method can accurately describe the dynamic stochastic system, the evolution and development process. Therefore this subject adopts the technique of simulation system to carry out research on this issue.
This subject is based on the theory and simulation technology of medical evacuation system, treatment treatment mechanism of sequence division module and each treatment module, providing quantitative basis for the simulation framework and research; implementation of the number of rescuing the wounded and living process, provide basic data support for the simulation analysis and construction of the wounded medical treatment; after the mathematical model, simulation analysis method, to provide support for the operation of logic simulation; simulation platform based on Simio, a 3D visual simulation system developed to provide a tool for the simulation research; finally build a simulation model using simulation system, combined with simulation experiments, the research to achieve the optimal allocation of medical equipment. The following are the specific content of the research:
(1) treatment group and treatment mechanism module series. According to the aging treatment and modern grading treatment theory, describes the classification management of medical treatment facility of wound treatment, taking a typical treatment institution as an example to analyze its service function; combining with the modular theory and method, analysis of wartime rescuing the wounded chain module, distinguish treatment module treatment institutions. On the basis of the above work, according to the scope of treatment treatment mechanism, treatment measures and treatment process, treatment sequence construction treatment module, to provide quantitative basis for the simulation framework and research, provide structural support for the simulation system.
(2) the wounded medical evacuation and medical equipment configuration simulation based on the data of reference. The injury codes, combined with expert advice, the formation of this topic wounded classification methods; according to the specific operational situation, get sick and wounded a structure; through expert advice, clear the wounded cure priority, life-threatening degree for medical treatment of wounded basic data. Based on the analysis and treatment of the injury severity of ladder treatment the sick and wounded, get sick and wounded rescue work sequence, achieve quantitative studies on the process of rescuing the wounded. By consulting the experts, I get in the war when the wounded survival probability data to Weibull survival function based on curve fitting of the survey data, construction the wounded survival model, implementation of the number of the wounded survival process. The research in this part provides the basic data support for the whole simulation research and simulation system.
(3) model of the wounded medical evacuation and medical equipment configuration simulation concepts. This paper expounds the basic content and methods of object-oriented modeling and simulation framework; based on the analysis of modeling research and treatment chain module division simulation system function, constructing the hierarchical structure modeling object the wounded medical evacuation and sanitary equipment simulation system; through the analysis and construction of the sick and wounded generation, treatment and evacuation model, puts forward the simulation hypothesis, simulation method of each part, realize the description of the modeling object simulation system behavior and interaction. This part studies provide support for the operation of logic simulation and simulation system.
(4) the wounded medical evacuation and medical equipment configuration simulation system development. To compare the number of simulation software, choose Simio as the development platform, and discusses the modeling framework; analysis and design of database, construction of database using Access2007 simulation, and the interaction with the simulation system, solve the problem of data input simulation system; analyze the realization method of 3D virtual simulation, 3D entity library using 3D modeling tools, combined with Simio's virtual reality performance ability, solve the problem of 3D virtual simulation system performance; using the Simio simulation platform and object-oriented multi-level modeling advantages, a series of intelligent object development in wartime medical evacuation and medical equipment configuration simulation the necessary modeling, forming simulation object library, realize the modeling function of the system. The part of the simulation system The development section provides tools for simulation research.
(5) health equipment simulation model and simulation experiments. The simulation analysis of system subject development of medical equipment based on configuration simulation; based on the simulation system, build configuration simulation model of a chain of medical equipment in a medical treatment and evacuation contains the object, process model is constructed to verify the simulation system is convenient and effective in the medical equipment configuration modeling and simulation. Using the simulation model, the simulation experiment is conducted on medical equipment allocation problem typical, provides medical equipment allocation simulation research method and decision-making basis for the health service and scientific research personnel. This part is the research on the simulation of typical medical equipment configuration, for the application of the simulation system. Is the simulation of the case.
The innovation of this research is:
(1) for the module, treatment work sequence, the wounded survival model on the basis of the study, the number of wounded treatment and survival process, development of the sick and wounded medical evacuation simulation database, provides professional information platform for medical evacuation and medical equipment research field, it is important to study the number of the health service and equipment.
(2) analyzed by modeling and simulation system of grouping function, divides the modeling object of wartime wounded medical evacuation and sanitary equipment simulation, hierarchical structure of related objects. On the basis of establishing and analyzing the wounded generation model, the cure of rescuing the wounded chain model, rescuing the wounded model of medical institutions, medical treatment module for medical treatment of wounded model and casualty evacuation model, and analyzes the simulation methods of the models, for the development of the simulation system, provides a method for modeling and simulation and experimental research.
(3) two times the development of Simio simulation platform, respectively, to construct simulation database, solves the problem of the lack of data on the underlying simulation; developed a 3D entity library, combined with the Simio virtual reality representation, 3D virtual simulation, to solve the problem of poor performance in visual simulation research to develop; the modeling object library, realizes the development and integration in wartime medical evacuation and medical equipment configuration of a 3D visual simulation system, the simulation research provides professional tools for health service and scientific research personnel, to solve the method to modeling and Simulation of complex problems, to research and analysis of medical equipment from the overall medical support can also the decision maker's deployment, security, evaluation and development decision-making, will further improve the reliability and scientific decision-making and related research work.

【學位授予單位】：中國人民解放軍軍事醫(yī)學科學院
【學位級別】：博士
【學位授予年份】：2012
【分類號】：R82

【引證文獻】

相關(guān)期刊論文 前1條

1 李躍宇;洪沖沖;張旭;;某冰箱預裝線的工作站改進建模仿真[J];制造業(yè)自動化;2013年09期

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