目的探讨有创-无创序贯机械通气治疗慢性阻塞性肺疾病(COPD)并呼吸衰竭的临床疗效.方法将94例在汕头市第二人民医院收治的COPD急性加重期并肺部感染的患者随机分为两组,分别给予持续有创机械通气治疗组和有创-无创序贯机械通气治疗组.观察比较两组患者的呼吸频率、体温、心率、氧气分压和二氧化碳分压,感染指标C-反应蛋白(CRP)和降钙素原(PCT),治疗期间并发症人数,住院时长和机械通气时长,痰培养阳性人数,影像学改善情况和死亡人数.结果在治疗开始前、开始后48 h和72 h,有创-无创序贯治疗组和持续有创治疗组相比较,呼吸频率,体温、心率,氧气分压和二氧化碳分压,感染指标CRP和PCT均无显著统计学差异(P＞0.05);有创-无创序贯治疗组和持续有创治疗组相比较,治疗期间并发症人数,住院时长和机械通气时长具有显著统计学差异(P＜0.05),而痰培养阳性人数,影像学改善情况和死亡人数无显著统计学差异(P＞0.05).结论相较于持续有创通气,有创-无创序贯机械通气用于治疗COPD合并肺部感染虽然在肺部功能和感染恢复上无显著差异,但是其可以有效缩短机械通气时长和住院时长,降低并发症的发生率,值得推广.“,”Objective To investigate the clinical efficacy of invasive-noninvasive sequential mechanical ventilation in the treatment of chronic obstructive pulmonary disease (COPD) with respiratory failure. Methods Ninety-four patients with acute exacerbation of COPD and pulmonary infection admitted to our hospital were randomly divided into two groups: continuous invasive mechanical ventilation treatment group and invasive-non-invasive sequential mechanical ventilation treatment group. We observed and compared the respiratory rate, body temperature, heart rate, oxygen partial pressure and carbon dioxide partial pressure, infection index CRP and PCT, number of complications during treatment, hospitalization duration and mechanical ventilation duration, positive sputum culture, imaging improvement and death toll. Results The respiratory rate, body temperature, heart rate, oxygen partial pressure and carbon dioxide partial pres?sure, infection index CRP and PCT were compared between the invasive-non-invasive sequential treatment group and the continuous invasive treatment group before treatment, 48 h and 72 h after the start of treatment. There was no statistically significant difference (P＞0.05). There was a statistically significant difference in the number of complications, hospitaliza?tion durations and mechanical ventilation duration between the invasive-non-invasive sequential treatment group and the continuous invasive treatment group (P<0.05). There was no statistically significant difference in the improvement of imag?ing and the number of deaths (P＞0.05). Conclusion Compared with continuous invasive ventilation, invasive-non-inva?sive sequential mechanical ventilation for the treatment of COPD with pulmonary infection has no significant difference in lung function and infection recovery, but it can effectively shorten the duration of mechanical ventilation and length of hospital stay. Reducing the incidence of complications is worth further promotion and application in the clinic.