目的探讨有创无创机械通气治疗慢性阻塞性肺疾病合并严重呼吸衰竭的疗效。方法慢性阻塞性肺疾病合并呼吸衰竭患者40例,给予抗感染和平喘等治疗;采用气管插管进行有创机械通气。患者出窗后随机分为两组,分别为序贯治疗组和对照组,各20例,序贯治疗组出窗后立刻拔出插管,接着采用口鼻面罩双水平气道正压通气;对照组继续行有创机械通气。分别对序贯治疗组和对照组患者总机械通气和住院时间,呼吸机相关性肺炎发生率,治疗死亡率进行比较。结果与对照组比较,序贯组各项指标明显较低。结论有创无创机械通气治疗慢性阻塞性肺疾病合并呼吸衰竭效果良好,值得临床推荐使用。 Objective To investigate the curative effect of invasive noninvasive mechanical ventilation on chronic obstructive pulmonary disease combined with severe respiratory failure. Methods Forty patients with chronic obstructive pulmonary disease and respiratory failure were given anti-infective and antiasthmatic treatment. The tracheal intubation was performed with invasive mechanical ventilation. Patients were randomly divided into two groups after the window, respectively, sequential treatment group and control group, 20 cases, sequential treatment group immediately pull out the intubation after the window, followed by oral and nasal masks bi-level positive airway pressure; The control group continued invasive invasive ventilation. Respectively sequential treatment group and control group patients with total mechanical ventilation and hospital stay, ventilator-associated pneumonia incidence, treatment mortality were compared. Results Compared with the control group, the indicators in the sequential group were significantly lower. Conclusion The invasive non-invasive mechanical ventilation for chronic obstructive pulmonary disease combined with respiratory failure with good results, it is recommended for clinical use.