随着经济的快速发展、医改政策不断地推进和深化、医疗卫生需求不断地增长，医疗废弃物的产生量变得越来越多。而正确、合理地处理医疗废弃物是我国目前亟待解决的问题之一。然而近年不断地曝出一些医疗废弃物非法加工的新闻，这些非法加工的黑作坊将医疗废弃物经过简单粗陋地加工，将其变成儿童玩具、餐具以及一些一次性用品等流入消费市场。医疗废弃物在没有经过严格地消毒杀菌便被重新投放到消费市场，不仅对接触的人群造成极大的危害、对环境也会造成巨大的污染，并且使一部分可循环利用的资源浪费。针对这一现实存在的问题，为了使医疗废弃物够得到规范化的回收处理，构建合理的医疗废弃物逆向物流网络十分必要。

      本文在对国内外相关研究文献分析的基础上，结合我国医疗废弃物处理的现状，总结了目前我国医疗废弃物回收处理逆向物流存在的问题，将医疗废弃物的特性——有害性、有毒性和传染性等因素考虑在内，构建了医疗废弃物逆向物流网络。该逆向物流网络层级结构包含3层——回收层、检测处理层、处置层。回收层主要是对医疗废弃物进行合理的回收、简单的分类包装等工作；检测处理层主要是对回收层收运的医疗废弃物进行毒、害性地检测、再利用价值地检测等，对有毒害性的废弃物进行无毒无害化处理；处置层有两种功能的节点设施，即再加工中心和填埋厂，再加工中心主要是接收检测处理中心送来的存在利用价值的废弃物；填埋厂主要是对没有利用价值的废弃物填埋处置。

      对于医疗废弃物逆向物流网络模型的建立，医疗废弃物产生量的不确定性对逆向物流网络节点选址及路径规划会产生比较大的影响。造成产生量不确定性有多方面原因：季节性、流行病等因素影响；每个医疗机构的相应等级不同、主营业务不同、同一个医疗机构每天服务的患者病情不相同等因素影响；都可能导致医疗废弃物的产生量具有很大的不确定性。因此针对该医疗废弃物逆向物流网络，将产生量的不确定性考虑在内建立了以成本最小化为目标、带有模糊参数的医疗废弃物逆向物流网络规划模型，并且设计了遗传算法对该模型进行求解分析。

      最后本文以西安市为例，在实地调查的基础上，分析了西安市医疗废弃物回收处理状况。结合实地调查和专家意见，对模型参数进行设定，将医疗废弃物产生量清晰化，利用Matlab软件对模型求解，得到了西安市医疗废弃物逆向物流网络设计模型：6个检测处理中心、1个再加工中心、1个填埋厂，与西安市目前的综合处理设施相比，设施的服务范围更加精准明确、能够有效减少医疗废弃物在医疗机构的堆积时间，降低了医疗废弃物传染的可能性；在一个回收周期内，优化的医疗废弃物逆向物流网络比当前原有的逆向物流网络成本节约了56%，从而验证了医疗废弃物逆向物流网络模型与算法设计的合理性及有效性。

With the rapid development of economy and the constant promotion and deepening of medical reform policies, the people's demand for medical and health care is growing. As a result, the annual production of medical waste keeps increasing, and the correct and reasonable disposal of medical waste is one of the urgent problems in China. However, in recent years, there have been some news about the illegal processing of medical waste. These illegal processing workshops turn medical waste into children's toys, tableware and some disposable goods by simple and crude processing. Medical waste is put back into the consumer market without strict disinfection and sterilization, which not only causes great harm to the people it comes into contact with, but also causes great pollution to the environment and wastes part of recyclable resources. In view of this practical problem, it is necessary to establish a reasonable reverse logistics network for medical waste in order to achieve standardized recovery and treatment of medical waste.

In this paper, based on the analysis of relevant research literature at home and abroad, combined with the current situation of medical waste treatment in China, the existing problems in the reverse logistics of medical waste recovery and treatment in China were put forward, and the reverse logistics network in line with the particularity of medical waste was established. The reverse logistics network hierarchy consists of three layers: recovery layer, detection and processing layer, and disposal layer. The recovery layer is mainly responsible for reasonable recovery of medical waste and simple classification and packaging. The detection and treatment layer is mainly used to detect the toxicity and harmfulness of the medical waste collected and transported in the recovery layer, and detect whether there is any reuse value, etc., and conduct non-toxic and harmless treatment on the toxic waste, and then send the waste to the disposal layer. The disposal floor has two functional nodal facilities, the reprocessing center and the landfill. The reprocessing center receives the waste with utilization value sent by the testing and treatment center, while the waste without utilization value is directly sent to the landfill.

Because the quantity of medical waste is uncertain: seasonal, epidemic and other factors; The corresponding level of each medical institution is different, the main business is different, the patient condition of the same medical institution is not the same every day and other factors; Are likely to lead to the production of medical waste with great uncertainty. For the establishment of the model of the reverse logistics network of medical waste, the uncertainty of the production of medical waste has a great impact on the site selection and path planning of the node of the reverse logistics network. Therefore, for this medical waste reverse logistics network, the planning model of medical waste reverse logistics network with fuzzy parameters with the goal of minimizing cost was established taking the uncertainty of production into consideration, and the genetic algorithm was designed to solve and analyze the model.

Finally, taking xi 'an city as an example, this paper analyzes the recovery and treatment of medical waste in xi 'an city on the basis of field investigation. Combining the field survey and expert opinion, the model parameters are set, the medical waste production clarifications, using Matlab software to solve the model, the xi 'an medical waste reverse logistics network design model: six detection processing center, 1 again processing center, 1 landfill plant, compared with before optimization of comprehensive treatment facilities, facilities more accurate service scope clear, can effectively reduce medical waste in the accumulation of time, medical institutions to reduce the likelihood of infectious medical waste; Within a cycle of recycling, the optimized reverse logistics network of medical waste can save 56% of the cost compared with the current original reverse logistics network, thus verifying the rationality and effectiveness of the model and algorithm design of the reverse logistics network of medical waste.

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