Abstract: Objective　To explore the effects of 37 ℃ intubation humidification versus 34 ℃ mask humidification on respiratory function and complications in children undergoing non-invasive positive pressure ventilation (NPPV) after congenital heart disease (CHD) surgery. Methods　One hundred and ten children undergoing NPPV after CHD surgery at Pediatric Intensive Care Unit, Guangdong Provincial People's Hospital, Southern Medical University from January 2023 to January 2025 were selected for the randomized controlled trial, including 57 boys and 53 girls who were 11.00 (4.00, 14.00) months old. They were divided into Group A, taking 37 ℃ intubation humidification, and Group B, taking 34 ℃ mask humidification, by the random number table method, with 55 cases in each group. Both groups used the Fisher & Paykel MR850 humidifier to humidify their air tracts. The general data, complications (sputum viscosity, nasal bleeding, oropharyngeal dryness, etc.), and treatment effects [suction frequency, stuffy nose ventilation time, satisfaction rate with air tract humidification, comfort degree, and partial pressures of oxygen (PaO2), partial pressures of carbon dioxide (PaCO2), and oxygenation indexes (PaO2/FiO2) after 30 minutes' and 12 hours' ventilation] were compared between the two groups.The t test, non-parameter test, and χ2 test were used for the statistical analyses. Results　There were no statistical differences in the general data between the two groups (all P>0.05). The incidence rates of sputum viscosity, nasal bleeding, and oropharyngeal dryness in Group A were lower than those in Group B (all P<0.05). The stuffy nose ventilation time and ICU stay in Group A were shorter than those in Group B [49.0 (30.0, 77.0) h vs. 72.0 (44.0, 112.0) h and 16.0 (12.0, 22.0) d vs. 21.0 (14.0, 26.0) d]; the suction frequency in Group A was lower than that in group B [4 (1, 8) times/d vs. 8 (6, 8) times/d]; the satisfaction rate with air tract humidification and comfort score in Group A were higher than those in Group B [87.3% (48/55) vs. 9.1% (5/55) and 82.0±8.87 vs. 76.0±9.89]; there were statistical differences (all P<0.05). After 30 minutes' ventilation, there were no statistical differences in PaCO2, PaO2, and PaO2/FiO2 between the two groups (all P>0.05). After 12 hours' ventilation, the PaCO2 in Group A was lower than that in Group B [40 (36, 47) mmHg (1 mmHg=0.133 kPa) vs. 49 (45, 55) mmHg, P<0.05]; there were no statistical differences in PaO2 and PaO2/FiO2 between the two groups (both P>0.05). Conclusion　Application of 37 ℃ intubation humidification in children undergoing NPPV after CHD surgery can reduce sputum viscosity and respiratory tract complications, improve their respiratory function, satisfaction with air tract humidification, and comfort, shorten ventilator time and ICU stay, and promote their recovery.

Key words: Congenital heart disease, Surgery, Non-invasive positive pressure ventilation, Humidification temperature, Respiratory function, Child

摘要： 目的　探讨37 ℃插管湿化模式与34 ℃面罩湿化模式对先天性心脏病（CHD）术后无创正压通气患儿呼吸功能及并发症的影响。方法　采用随机对照研究，选取2023年1月至2025年1月入住南方医科大学附属广东省人民医院儿科重症监护室使用无创正压通气的CHD术后患儿110例为研究对象，其中男57例、女53例，月龄11.00（4.00，14.00）个月。按照分配比1∶1随机数字表法分成A组（37 ℃插管湿化模式）和B组（34 ℃面罩湿化模式），每组55例，均采用费雪派克MR850湿化器进行气道湿化。比较两组患儿一般资料、并发症（痰液黏稠、鼻腔出血、口咽干燥等）、治疗效果［吸痰频率、鼻塞通气时间、气道湿化满意率、舒适度及通气30 min与12 h后动脉血氧分压（PaO2）、二氧化碳分压（PaCO2）、氧合指数（PaO2/FiO2）等］。采用t检验、非参数检验、χ2检验进行统计分析。结果　两组患者一般资料比较，差异均无统计学意义（均P>0.05）。A组痰液黏稠度、鼻腔出血率及口咽干燥发生率均低于B组，差异均有统计学意义（均P<0.05）。A组鼻塞通气时间［49.0（30.0，77.0）h比72.0（44.0，112.0）h］、ICU住院时间［（16.0（12.0，22.0）d比21.0（14.0，26.0）d］均短于B组，吸痰频率低于B组［4（1，8）次/d比8（6，8）次/d］，气道湿化满意率［87.3%（48/55）比9.1%（5/55）］、舒适度评分［（82.0±8.87）分比（76.0±9.89）分］均高于B组，差异均有统计学意义（均P<0.05）。通气30 min后，两组PaCO2、PaO2、PaO2/FiO2比较，差异均无统计学意义（均P>0.05）。通气12 h后，A组PaCO2水平为40（36，47）mmHg（1 mmHg=0.133 kPa），B组为49（45，55）mmHg，差异有统计学意义（P<0.001）；两组PaO2、PaO2/FiO2水平比较，差异均无统计学意义（均P>0.05）。结论　CHD术后无创正压通气患儿采用37 ℃插管湿化模式可有效稀释痰液、减少呼吸道并发症、改善呼吸功能，提升气道湿化满意率，增加患儿舒适度，并缩短呼吸机使用时间及ICU住院时间，加快患儿身体恢复。

关键词: 先天性心脏病, 外科手术, 无创正压通气, 湿化温度, 呼吸功能, 儿童