摘要目的:探讨密闭式吸痰结合恒速小量持续气道湿化对急性呼吸窘迫综合征的影响。方法:选择2016年8月至2018年8月本院收治的急性呼吸窘迫综合征患者108例，按照随机数字表法分为两组，各54例。对照组行开放式吸痰和间断气道湿化干预，观察组行密闭式吸痰结合恒速小量持续气道湿化干预。对比两组插管后24 h、72 h、120 h痰液黏稠度、痰痂形成情况及吸痰后不同时间血氧饱和度变化，并统计两组不良反应发生率。结果:观察组患者插管后72 h、120 h痰液黏稠Ⅲ度及痰痂形成率分别为3.70%（2/54）、1.85%（1/54）、1.85%（1/54）、5.56%（3/54），均低于对照组的16.67%（9/54）、53.70%（29/54）、14.81%（8/54）、20.37%（11/54），差异均有统计学意义（均 P＜0.05）；观察组患者吸痰后1 min、3 min、5 min的血氧饱和度（85%～95%）分别为25.93%（14/54）、87.04%（47/54）、100.00%（54/54），均高于对照组的0.00%（0/54）、0.00%（0/54）、1.85%（1/54），两组比较差异均有统计学意义（均 P＜0.05）；观察组吸痰过程、气道湿化过程的不良反应发生率均低于对照组，差异均有统计学意义（均 P＜0.05）。 结论:密闭式吸痰结合恒速小量持续气道湿化应用于急性呼吸窘迫综合征患者，可减轻痰液黏稠度，有效预防痰痂形成，提高血氧饱和度，减少不良反应，值得推广。

abstractsObjective:To investigate the effect of closed endotracheal suction combined with constant-velocity and small-amount continuous airway humidification on acute respiratory distress syndrome.Methods:A total of 108 patients with acute respiratory distress syndrome admitted to our hospital from August 2016 to August 2018 were enrolled and were divided into two groups according to the random number table method, 54 cases in each group. The control group received open endotracheal suction and intermittent airway humidification, and the observation group received closed endotracheal suction combined with constant-velocity and small-amount continuous airway humidification. The sputum viscosity and the formation of sputum scab after intubation for 24 h, 72 h, and 120 h, and the changes of blood oxygen saturation at different time points after suction were compared between the two groups, and the incidence of adverse reactions was counted in the two groups.Results:The rates of grade Ⅲ sputum viscosity and sputum scab formation in the observation group after intubation for 72 h and 120 h were 3.70(2/54),1.85% (1/54), 1.85% (1/54), 5.56% (3/54), which were lower than those in the control group 16.67%(9/54),53.70%(29/54), 14.81% (8/54), 20.37% (11/54)], with statistically significant differences (all P<0.05). The rates of 85%-95% blood oxygen saturation 1 min, 3 min, 5 min after suction in the observation group were 25.93% (14/54), 87.04% (47/54), 100.00% (54/54), which were higher than those in the control group [0.00% (0/54), 0.00% (0/54), 1.85% (1/54)], with statistically significant differences (all P<0.05). The incidences of adverse reactions in the observation group during the process of suction and airway humidification were lower than those in the control group, with statistically significant differences (both P<0.05). Conclusion:Closed endotracheal suction combined with constant- velocity and small-amount continuous airway humidification in patients with acute respiratory distress syndrome can reduce the viscosity of sputum, effectively prevent the formation of sputum scab, improve blood oxygen saturation, reduce adverse reactions, which is worth promoting.