考虑伤情分类的灾后创伤伤员救治与转运路径优化研究

Research on the Route Optimization of Ambulance Treatment and Transportation after Disaster Based on the Injured Classification

大规模自然灾害下极易产生大量创伤类伤员,对创伤伤员的快速抢救,是灾后救援工作的核心内容。为了实现大规模自然和事故灾难后伤员的快速救治与安置,提高救护车资源的利用率,本文提出了考虑伤员伤情分类的高效伤员救治与转运救援模式,即救护车对轻伤员实施就地救治,对重伤员进行转运医院后急救。根据伤员救治时效理论引入创伤指数计算等待期内轻重伤员的伤情变化,以伤员群体创伤指数之和最小作为优化目标,建立了多车程、需求可拆分的救护车VRP数学模型,并设计了基于车程的邻域搜索的模型快速求解算法,算例仿真和对比研究验证了模型和算法的有效性,给出了大规模自然与事故灾难后伤员分类救治与转运模式下的救护车路径方案。

The rescue of the wounded after the disaster is the core of the post disaster relief work.The number of ambulances compared to the quantity of casualties is obviously insufficient,so the rescue to the wounded is very difficult.However,the severity of the wounded is on the different level.According to'Emergency Time Window'theory,rescuing those who are badly wounded in the first hours after disaster can greatly improve their chance of survival.Beyond the'Emergency Time Window',the badly wounded have less rescuing value than the slightly wounded gradually.In short,the wounded should be classified according to their different characteristics and ambulance resources should be coordinated.In this context,in order to achieve rapid treatment and placement of the wounded in large-scale disaster,and improve the utilization rate of ambulance resources,the triage treatment and transportation rescue mode,namely taking local treatment to the slightly injury and transporting the badly wounded into hospital by ambulances is proposed.Trauma index is used to calculate the change of the severity of the wounded during the waiting period.The optimization goal is to minimize the trauma index of all wounded,and the Multi-Trip,Split-Demand ambulance VRP mathematical model(MTSD-VRP)is established.Based on the aboveissues,an approach base-on tabu search algorithm considering vehicle trips is developed for ambulance path optimization.The algorithm uses the'vehicle trip pool'to preserve the trips in better solution and generate new trips,and design the search operator and search strategy based on the trip.The algorithm flow mainly includes the trip generating process,the trip distribution process and the trip refreshing process.The simulation result shows that the MTSDVRP model and the tabu search algorithm is suitable for ambulance path optimization with wounded classification.The data used in numerical simulation is primarily references to the actual situation of Ya'an City,Sichuan Province.The MTS-DVRP model with wounded classification and the tabu search algorithm based on the vehicle trip can be used as reference for other related studies.