战时伤病员医疗后送及卫生装备配置仿真研究

发布时间：2018-01-05 11:31

本文关键词：战时伤病员医疗后送及卫生装备配置仿真研究　出处：《中国人民解放军军事医学科学院》2012年博士论文　论文类型：学位论文

【摘要】：当前，军事思想、编制体制、作战行动和保障方式有了很大变化，对卫勤保障能力提出了新的要求。信息化条件下卫勤保障的基本特征是一体化的联勤保障和灵活机动的卫勤战术，卫勤力量要实现更好的机动性和更快的反应，这对卫生装备的优化配置提出了更高的要求。合理优化配置卫生装备，对于提高战时伤病员的治愈归队率，降低伤死率、病死率和残疾率，进而维护和提高整个部队的战斗力具有重要的意义。战时伤病员医疗后送及卫生装备配置问题，涉及众多的动态性和随机性因素问题，属于复杂的动态随机系统问题。而传统的解析方法通常用于处理静态的、规范的、简单几率性的问题，在处理复杂问题时，往往需要做出很强的简化假设，这影响了模型的有效性。与之相比，仿真方法可以比较真实地描述动态随机系统的运行、演变及其发展过程。因此本课题采用系统仿真技术对这一问题开展研究。本课题以医疗后送理论和系统仿真技术为基础，划分救治机构的模块和各救治模块的救治工作序列，为仿真研究提供数量化框架与依据；实现伤病员救治过程和生存过程的数量化，为仿真研究提供基础数据支撑；分析和构建伤病员医疗后送数学模型，分析模拟方法，为仿真研究提供运行逻辑支撑；以Simio仿真平台为基础，开发三维可视化仿真系统，为仿真研究提供工具；最后利用仿真系统构建仿真模型，结合仿真实验，实现卫生装备的优化配置研究。下面是课题研究的具体内容：（1）救治机构模块分组和救治工作序列研究。根据时效救治与现代分级救治理论，阐述救治机构战伤救治的分级管理，以某典型救治机构为例分析其勤务功能；结合模块化理论和方法，分析战时伤病员救治链的模块构成，区分救治机构的救治模块。在上述工作基础上，根据救治机构的救治范围、救治技术措施和救治工作流程，构建救治模块的救治工作序列，为仿真研究提供数量化框架和依据，为仿真系统运行提供结构支撑。（2）伤病员医疗后送及卫生装备配置仿真基础数据研究。参考美军伤情码，结合专家咨询，形成本课题伤病员分类方法；针对具体作战情景，获取伤病员构成结构；通过专家咨询，明确伤病员救治优先级、生命威胁程度等伤病员救治基础数据。通过对伤病员在各救治阶梯伤病情和救治措施的分析，获取伤病员救治工作序列，实现伤病员救治过程的数量化研究。通过专家咨询，获取我军战时伤病员生存概率数据，以Weibull生存函数为基础，对调研数据进行曲线拟合，构建伤病员生存模型，实现伤病员生存过程的数量化研究。该部分研究为整个仿真研究和仿真系统运行提供基础数据支撑。（3）伤病员医疗后送及卫生装备配置仿真概念模型研究。阐述面向对象仿真建模框架的基本内容和方法；根据救治链模块划分研究和仿真系统建模功能分析，构建伤病员医疗后送及卫生装备配置仿真系统建模对象的层次结构；通过分析和构建伤病员生成、救治和后送模型，提出仿真假设，分析各部分的模拟方法，实现对仿真系统建模对象行为和交互描述。该部分研究为整个仿真研究和仿真系统提供运行逻辑支撑。（4）伤病员医疗后送及卫生装备配置仿真系统开发。对众多仿真软件进行比较，选择Simio作为开发平台，，并阐述其建模框架；进行数据库数据分析与设计，利用Access2007构建仿真底层数据库，并与仿真系统进行了交互，解决了仿真系统的数据输入问题；分析了三维虚拟仿真实现方法，利用三维建模工具构建三维实体库，结合Simio的虚拟现实表现能力，解决了仿真系统的三维虚拟表现问题；利用Simio仿真平台面向对象和多层次建模的优势，开发战时伤病员医疗后送及卫生装备配置仿真建模所需的一系列智能对象，形成仿真建模对象库，解决了系统的建模功能实现问题。该部分为仿真系统的开发部分，为仿真研究提供工具。（5）进行卫生装备配置仿真模型与仿真实验研究。分析了基于课题开发的仿真系统的卫生装备配置仿真研究过程；依据仿真系统，构建某救护所和包含后送对象的某救治链卫生装备配置仿真模型，模型的构建过程验证了仿真系统在卫生装备配置仿真建模方面的便捷性和有效性。利用上述仿真模型，对典型的卫生装备配置问题进行仿真实验研究，为卫勤机关和科研人员提供了卫生装备配置仿真研究方法和决策依据。该部分是典型的卫生装备配置仿真研究，为仿真系统的应用部分，也是仿真研究的案例部分。本课题研究的创新之处：（1）以救治模块、救治工作序列、伤病员生存模型研究为基础，实现了伤病员救治过程和生存过程的数量化研究，开发了伤病员医疗后送仿真底层数据库，为医疗后送和卫生装备研究领域提供了专业信息平台，对卫生勤务与装备的数量化研究具有重要的意义。（2）利用模块分组研究和仿真系统建模功能分析，划分了我军战时伤病员医疗后送及卫生装备配置仿真的建模对象，构建了相关对象的层次结构。在此基础上，构建和分析了伤病员生成模型，救治链伤病员救治模型、救治机构伤病员救治模型、救治模块伤病员救治模型，以及伤病员后送模型，并分析了各模型的模拟方法，为该领域仿真系统开发、仿真建模和实验研究提供了技术方法。（3）对Simio仿真平台进行二次开发，分别构建了仿真底层数据库，解决了以往仿真研究底层数据匮乏的问题；开发了三维实体库，结合Simio的虚拟现实表现能力，实现了三维虚拟仿真，解决了以往仿真研究视觉表现差的问题；开发了建模对象库，实现了战时伤病员医疗后送及卫生装备配置三维可视化仿真系统的开发与集成，为卫勤机关和科研人员提供了专业的仿真研究工具，解决了以往仿真研究建模方法繁琐复杂的问题，也使得决策者可从卫勤保障的整体来研究和分析卫生装备的部署、保障、评价以及发展决策，将进一步提高相关决策和研究工作的可靠性和科学性。
[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.

【学位授予单位】：中国人民解放军军事医学科学院
【学位级别】：博士
【学位授予年份】：2012
【分类号】：R82

【引证文献】