对慢性阻塞性肺疾病（ＣＯＰＤ）慢性呼吸衰竭急性加重，ＰａＣＯ２＞９３ｋＰａ，并出现神志改变的患者１２例（年龄６４９±１０１岁），进行面（鼻）罩压力支持通气治疗。结果：应用较高的压力支持水平（ＩＰＡＰ２６６±２４ｃｍＨ２Ｏ）可使应用原型号（ＢｉＰＡＰ２０）呼吸机效果欠佳的患者通气明显改善。ＰａＣＯ２下降（１１８５±１２ｖｓ８７１５ｋＰａ，Ｐ＜００５），ＰａＯ２升高（７８±１７ｖｓ１６８±２３Ｐ＜００５），呼吸肌疲劳改善，症状减轻，减少建立人工气道的可能性。在ＢｉＰＡＰ高压力水平通气早期，建议用面罩通气，保证气道的通畅性；较长时间应用时尚须注意加强湿化，定期调整参数并注意监测。 12 patients (age 649 ± 101 years) with acute respiratory failure in chronic obstructive pulmonary disease (COPD), PaCO2> 93kPa and conscious changes were treated with facial (nasal) mask pressure supportive ventilation treatment. RESULTS: The use of a higher pressure support level (IPAP 26.6 ± 2.04cmH2O) significantly improved ventilation in patients who did not respond well to the use of a prototype BiPAP20 ventilator. PaCO2 decreased (1185 ± 12vs8715kPa, P <005), PaO2 increased (78 ± 17vs168 ± 23P <005), respiratory muscle fatigue improved, Reduce the symptoms, reduce the possibility of establishing artificial airway. In the early stage of BiPAP high pressure ventilation, it is recommended to use mask ventilation to ensure airway patency; longer application of fashion should pay attention to strengthening wetting, regular adjustment of parameters and pay attention to monitoring.