A Basic Study Of The Rescue And Treatment Of Maxillofacial Trauma By Application Of The Information Resource Management And Artificial Intelligence

With the development of the society, trauma has become the prominent problem which threatens the human life and the health. The rescue, treatment and prevention of trauma has been put more and more emphasis by the government and medical researcher. Because of the special anatomical and physiological characteristics in oral and maxillofacial region, maxillofacial injuries are frequently found in multiply injured patients. Facial injury may cause permanent derangement of functions and destroy of facial appearance, which is different from injuries in other regions. How to effectively prevent, relieve and rehabilitate the facial deformity and functional derangement after the facial injuries is an extraordinary important subject.Multi-layers management is required for the trauma treatment. The procedure of management include rescue at the secene of the trauma, prehospital rescue, managements at the hospital and professional managements, it is necessary that the management should be professional, consecutive and timely. It is give more emphasis to the rescue at a moment's notice, stable resuscitation and consecutive managements for the management of the war-wounded than for the conventional gunshot wound. The level of professional managements for maxillofacial trauma in our country is higher, however, there still has a huge gap in the rescue at the secene of the trauma, prehospital rescue, management at the hospital compared with the developed countries. The managements of malhealed and obsolete fractures, bone nonunion, infection, function derangement, secondary deformities are very difficult. In order to improve the level of the rescue and treatment for maxillofacial trauma in our country, the chief task is to enhance the level of professional managements at the initial stage.Although there have been lots of prominent achievements at the research of maxillofacial trauma, however, it was noted that the lack of standard classification of injury and treatment is so severe that lots of maxillofacial trauma data have been lost, effective programs of injury prevention and care evaluation can not be accomplished. Standard case records play an important role in the field of trauma research. Therefore, it is obligatory to establish a maxillofacial trauma registry and information systems and standard maxillofacial trauma score system. The data collected by trauma registries are the key to the accurate determination of outcome statistics (both morbidity and mortality). It is critical to health planners and managers as they devise new trauma systems, improve existing programs, and determine the medical, economic, and medicolegal impacts of trauma care. The system should not only be accord with the demand of a routine medical database, but also need canonical, standard and professional registry sheets.Nowadays, the main directions and contents of the study of the management for facial injuries are how to exactly apply the concrete treatment procedures and projects in good time. In order to implement trauma triage and rescue by rule and line at the warfare, to be high-levelly and professionally cared and treated at the evacuation, to offer scientific plastic and reconstructive projects, to rehabilitate the facial appearance and function at the most, and to effectively relieve the ratio of mortality and morbidity after facial injuries,we designed and implemented the Maxillofacial Trauma Information Systems and Intelligent Decision Support Systems(Oral and Maxillofacial trauma Aid, OMF Trauma Aid) by the application of the information and artificial intelligence technology, and offer a knowledge acquisition and management and inference model which can be used to implement other anatomic region traumaAID.Major results and conclusions from the studies are:1. We designed canonical, standard and professional maxillofacial trauma registry sheets. The contents of the sheets include the epidemiological data, the treatment methods and outcome of the facial injuried patients. It was especially important at the research that we defined etiology of injury by causes and mechanisms of injury, and that we designed a revised anatomical classification of maxillofacial injuries which included more detailed and exact informationof the injury.2. Microsoft SQL Server 2000 that can support telematic was used to set up Database server. C++ Builder was adopted to develop desktop application. Eight functional modules were developed in system, which were clinical data, injury severity score, user management, data inspection, search, statistic analysis, follow-up survey, system maintenance. The system has friendly interfaces. A majority of contents can be chosen by pull-down menus. All menus linked exact explanation of the professional glossary by"Hint"technique. The search, correction, statistic analysis, report forms creation of the trauma data can easily by realized according to the authority of the users.System has satisfactory stability, security, compatibility, and specialty. Manipulation is convenient, and it can easily be upgraded. Statistical calculation is accurate. It can be used to collect standard cases of maxillofacial trauma and to do a collaborative research on the epidemiological characteristics, treatment, and outcome of facial injuries.3. The Client/Server and Browser/Server database structure were applied to achieve telematic. By distribution technology in development, the data are distributed at different hospitals, however they formed a whole database logically. The storage of trauma data is spatially separated from the application system. Every hospital can not only manage and analyze his own trauma data, but also can share the trauma data resource by telecommuting. It is the basis of the construction of the large-scale maxillofacial trauma databases. With the help of the system, we can share the data and collect large numbers of standardized and complete maxillofacial trauma cases for epidemiology and outcome investigation in China, which can bring forward effective proposals for the prevention and management of maxillofacial trauma, and monitor and instruct the managements for facial injuries4. To correct the limitation of the AIS, RAMIS was coded by the addition of two places of decimals to AIS based on the classification of maxillofacial trauma, which is a new direction to revise the maxillofacial injury severity score system. By evaluation, it can more accurately evaluate the maxillofacial injury severity and differentiate the difference between the multiple and one-site maxillofacial trauma. We implemented a maxillofacial injury severity score software, which is a module of the information system. The GCS, RTS, ISS, RFISS, and MISS of all data can be automatically calculated and analyzed according to the code rules of AIS and RAMIS.5. We present the knowledge of the management for OMF trauma with Frame Theory and Semantic Network based on Object-oriented technology in our study. The decision-making tree was constructed. Inference Control Language was used to express experts'knowledge and control the inference process. The system realized a visualized knowledge acquisition and management by friendly interface and solved the bottle-neck problem of the traditional expert system at the Knowledge Acquisition stage. We can conveniently add, amend and delete the knowledge of the OMF trauma, and can maintain knowledge base. The system can automatically get more knowledge and rules by Symbol Machine Learning. In our research, we also performed the basic study of the application the case-based reasoning to OMF trauma Aid, which improve the intelligent level of the system..6. The OMF Trauma IDSS can be used to intelligently diagnose in good time, assess the injury severity according to the change of the injury, and adjust the diagnosis and management plans. The ability to manage OMF trauma can be enhanced by making use of the system. The ratio of mortality and morbidity after facial injuries is excepted to be effectively relieve. The system can be applied as a embedded software or Web Pages Background. Users are distributed in different clients port, however the diagnosis is focused on server, which make the interactive telemedicine of the trauma rescue possible at the warfare. The study also provide a model which can be used to implement other anatomic region traumaAID Decision Support System in order to develop trauma aid group decision support system by the help of the parallel reasoning algorithm and distributive implementation at next step.