| 摘要: |
| 目的 构建一种炭疽气溶胶恐怖事件医学处置效果的量化评估方法。方法 首先构建炭疽暴露后医学干预的决策树模型、关键资源消耗配置模型及不同干预措施下人群状态转移模型，从而形成一个资源约束下炭疽事件医学处置效果的评估框架。然后基于离散事件仿真技术，以我国大城市遭受炭疽恐怖袭击为情景，分析评估52种干预策略对发病人数、峰值、死亡人数的影响。结果 干预效果对介入延迟时间和资源储备量2个因素均敏感。在仿真案例中，当介入延迟时间为事发后1 h时，将资源储备量从25%提高到100%可减少约59.91%的死亡人数；当介入延迟时间为事发后145时，将资源储备量从25%提高到100%只能减少约7.33%的死亡人数。干预策略对发病人数达到峰值的时间影响很小，最大值为10.52 d，最小值为9.67 d；对峰值人数影响较大，最大值为255 072人，最小值为103 943人。结论 建立了一种炭疽气溶胶恐怖事件医学处置效果的定量评估方法，在医学救援能力建设、应急策略选择方面具有一定的参考价值。 |
| 关键词: 炭疽 生物恐怖 医学干预 状态转移模型 仿真评估 |
| DOI：10.16781/j.0258-879x.2019.02.0178 |
| 投稿时间：2018-11-26修订日期：2019-02-15 |
| 基金项目:国家重点研发计划（2017YFC1200300），国家自然科学基金（71673294，71403287），国家重点实验室开放研究基金（SKLPBS1433）. |
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| An evaluation method for medical intervention effect of urban anthrax aerosol terrorist attacks |
| ZHANG Bin1,XU Qing1,YE Ling-ling1,DU Fei2,ZU Zheng-hu1*,ZHENG Tao1* |
(1. Institute of Biotechnology, Academy of Military Medical Sciences, Academy of Military Sciences, Beijing 100071, China;
2. Academy of Military Medical Sciences, Academy of Military Sciences, Beijing 100850, China
*Corresponding authors) |
| Abstract: |
| Objective To establish a quantitative evaluation method for medical treatment effect of anthrax aerosol terrorist attacks. Methods We established an evaluation framework for the medical treatment effect of anthrax events through constructing the decision tree model of medical intervention after anthrax exposure, the allocation model of key resources consumption and the model of population state transition under different intervention measures. Then, under the scenario of the anthrax terrorist attacks in the big cities of China, we analyzed and evaluated the effects of 52 intervention strategies on the number of cases, peak value, and deaths based on the discrete event simulation method. Results The intervention effect was sensitive to time delay in intervention and resource reserve. When time delay in intervention was 1 h after the attack, the resource stock increase from 25% to 100% could reduce the deaths by 59.91%; while only about 7.33% of the deaths were reduced when the intervention was performed at 145 h after the attack. The intervention strategy had little effect on the peak time of the morbidity, with the maximum value being 10.52 d and the minimum value being 9.67 d; but it had a greater impact on the peak number of patients, with the maximum value being 255 072 patients and the minimum value being 103 943 patients. Conclusion A quantitative evaluation method for medical treatment effect of anthrax aerosol terrorist attacks is established in this study, and it may be conducive to medical rescue capacity building and emergency strategy-making. |
| Key words: anthrax bioterrorism medical intervention state transition model simulation evaluation |
