基于Petri网的急危重症院前急救流程优化研究

发布时间：2018-02-25 18:48

本文关键词： 急危重症院前急救 Petri网马尔可夫链流程优化　出处：《山东大学》2015年硕士论文　论文类型：学位论文

【摘要】：院前急救是急救医疗服务体系中最重要的一个环节,它在维护人民健康和社会安定方面,发挥着不可取代的作用。在我们周围,每天都会有很多急危重症病例的发生,院前急救工作面临的任务非常艰巨。在急救指挥中心调度员受理急救电话并制定调派计划后,急救小组需要快速出诊,以尽可能快的速度到达指定地点对患病或受伤人员进行紧急处理,然后将患者运送回医院,倾尽全力挽救患者的生命。院前急救的时间每缩短一秒钟,患者生命的延续就多一份可能。随着社会的进步,我国对院前急救工作越来越重视,但与国外的急救数据进行对比后发现,我国的院前急救工作依然存在很多问题,急危重症患者在院前急救中的生存率极低,对院前急救进行优化改进势在必行。近些年来,我国对于院前急救领域的研究越来越多,但是缺乏通过建模对院前急救流程进行优化的研究。所以,本文利用相关工具对院前急救流程进行建模分析、确定流程的瓶颈环节并进行优化,以此减少院前急救的时间,提高院前急救流程的效率。首先,本文通过对当前急危重症院前急救背景的分析和对急救领域国内外文献的综述,确定了运用相关建模工具对院前急救流程进行建模研究的必要性。然后,对院前急救、流程优化、常用流程建模方法等进行了介绍,通过对流程建模方法的比较分析确定了用Petri网对急危重症院前急救流程进行建模分析。接下来,本文对国内院前急救流程的现状进行了描述和分析,考虑到我国院前急救模式的多样性和数据获取的难度,选取济南市急救中心作为分析对象。根据调研资料,确定急危重症院前急救流程的共性流程图,运用Petri网对其进行建模,并利用ExSpect仿真软件对Petri网模型进行多次仿真,确定流程各个环节的执行时间。最后,同构马尔可夫链计算出流程模型的稳态概率,通过对稳态概率的排序确定流程瓶颈,做出针对性分析,发现流程瓶颈中存在问题的原因,通过对急救中心专家咨询和查阅文献,提出相应的改进方案,对急危重症院前急救流程进行优化。通过优化前后流程各项执行时间的对比,确定本文的研究可以缩短急危重症的院前急救时间,在优化院前急救流程方面具有现实意义。
[Abstract]:Pre-hospital first aid is the most important link in the first-aid medical service system. It plays an irreplaceable role in maintaining the health and social stability of the people. The task of first aid before hospital is very arduous. After the dispatcher of the emergency command center receives the first aid call and formulates the dispatch plan, the first aid team needs to make a quick visit. Arrive at a designated place as quickly as possible for emergency treatment of a sick or injured person, and then transport the patient back to the hospital, with every effort to save the patient's life. With the progress of society, our country is paying more and more attention to the work of pre-hospital first aid. However, comparing with the data of emergency treatment abroad, we find that there are still many problems in the work of pre-hospital first aid in our country. The survival rate of critically ill patients in pre-hospital first aid is very low, so it is imperative to optimize and improve the pre-hospital first aid. In recent years, more and more researches have been done in the field of pre-hospital first aid in China. However, there is no research on how to optimize the pre-hospital first aid flow through modeling. Therefore, this paper uses the relevant tools to model and analyze the pre-hospital emergency flow, to determine the bottleneck of the process and to optimize, so as to reduce the time of pre-hospital first aid. First of all, through the analysis of the background of the current emergency emergency before hospital and the literature review of the field of emergency treatment, The necessity of modeling the pre-hospital first aid flow with relevant modeling tools is determined. Then, the pre-hospital first aid, process optimization, common process modeling methods and so on are introduced. Through the comparative analysis of process modeling methods, Petri net is used to model and analyze the pre-hospital emergency flow. Then, this paper describes and analyzes the current situation of pre-hospital emergency flow in China. Considering the diversity of pre-hospital emergency treatment mode and the difficulty of obtaining data, Jinan emergency center was selected as the analysis object. According to the investigation data, the general flow chart of emergency treatment flow chart was determined, and the Petri net was used to model it. The ExSpect simulation software is used to simulate the Petri net model for many times to determine the execution time of each link of the process. Finally, the stable probability of the process model is calculated by the isomorphic Markov chain, and the bottleneck of the process is determined by ranking the steady-state probability. To make targeted analysis, find out the causes of the problems in the process bottleneck, through consulting the experts of the emergency center and consulting the literature, put forward the corresponding improvement plan, Through the comparison of the execution time before and after the optimization, it is determined that the research in this paper can shorten the pre-hospital emergency time of the critical and critical cases, which is of practical significance in optimizing the pre-hospital emergency flow.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R459.7

【参考文献】