目的:探讨口/鼻面罩双水平气道正压通气(NPPV)治疗慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者的疗效。方法:将48例COPD急性发作并Ⅱ型呼吸衰竭患者随机分为治疗组和对照组,治疗组26例在对照组常规治疗的基础上,采用BiPAP呼吸机经口/鼻面罩正压通气,比较治疗前、后2、24小时两组同期动脉血气及呼吸频率、心率变化。结果:治疗组治疗2小时后PaO2均较治疗前明显改善(P<0.05),治疗24小时后PaO2、PaCO2均较治疗前明显改善(P<0.05),呼吸频率、心率改变也较治疗前明显改善(P<0.05);治疗后治疗组PaO2、PaCO2改善与对照组比较,差异有显著性意义(P<0.05)。结论:应用鼻(面)罩的无创性正压通气技术治疗慢性阻塞性肺疾病并发呼吸衰竭可提高PO2,降低PaCO2,改善肺功能。 Objective: To investigate the efficacy of oral / nasal mask bi-level positive airway pressure (NPPV) in patients with chronic obstructive pulmonary disease (COPD) complicated with respiratory failure. Methods: Forty-eight patients with acute exacerbation of COPD and type Ⅱ respiratory failure were randomly divided into treatment group and control group. In the treatment group, 26 patients were treated with BiPAP ventilator oral / nasal mask positive pressure ventilation on the basis of conventional treatment in the control group 2, 24 hours before treatment, two groups of arterial blood gas and respiratory rate, heart rate changes over the same period. Results: After 2 hours of treatment, PaO2 was significantly improved (P <0.05), PaO2 and PaCO2 in 24 hours after treatment were significantly improved (P <0.05), and respiratory rate and heart rate were also significantly changed than those before treatment (P <0.05). After treatment, the improvement of PaO2 and PaCO2 in the treatment group was significantly different from that in the control group (P <0.05). Conclusion: Noninvasive positive pressure ventilation with nasal mask can improve PO2, decrease PaCO2 and improve pulmonary function in patients with chronic obstructive pulmonary disease complicated by respiratory failure.