Abstract: Objective: To investigate the effects of invasive-noninvasive mechanical ventilation sequential therapy in treatment of chronic obstructive pulmonary disease (COPD) combined with respiratory failure. Methods: 88 COPD combined respiratory failure patients were divided into 2 groups according to the patients' wishes. The patients in control group (n=44) were given invasive mechanical ventilation, while the patients in observation group (n=44) were given invasive-noninvasive mechanical ventilation sequential therapy. The treatment-related indicators, blood gas analysis indexes, pulmonary function indexes and adverse events of patients in 2 groups were compared. Results: After treatment, the invasive ventilation time, total mechanical ventilation time, hospital stays of patients in observation group were obviously shorter than control group (P<0.05); PaO₂, FVC, FEV1 were obviously higher than control group (P<0.05); PaCO₂, and the incidence of weaning failure rate and VAP were obviously lower than control group (P<0.05). Conclusions: Invasive-noninvasive mechanical ventilation sequential therapy can shorten the mechanical ventilation time of COPD combined respiratory failure patients, improve pulmonary function and gas analysis indexes, reduce the incidence of adverse events, and is safe and reliable .

Key words: Chronic obstructive pulmonary disease (COPD), Respiratory failure, Invasive mechanical ventilation, Invasive-noninvasive mechanical ventilation sequential therapy

摘要： 目的:对探讨有创-无创机械通气序贯疗法用于慢性阻塞性肺疾病（COPD）合并呼吸衰竭的临床效果。方法:88例COPD合并呼吸衰竭患者依据患者意愿分为两组,对照组44例患者采用有创机械通气治疗,观察组44例患者采用有创-无创机械通气序贯疗法,比较两组治疗相关指标、血气分析指标和肺功能指标和不良事件发生情况。结果:治疗后,观察组患者有创通气时间、总机械通气时间、住院时间明显短于对照组,PaO₂、FVC、FEV1明显高于对照组,PaCO₂、撤机失败率、VAP发生率明显低于对照组,差异具有统计学意义（P<0.05）。结论:有创-无创机械通气序贯疗法可缩短COPD合并呼吸衰竭患者机械通气时间,改善患者肺功能和血气分析指标,降低不良事件发生率,且安全可靠。

关键词: 慢性阻塞性肺疾病（COPD）, 呼吸衰竭, 有创机械通气, 有创-无创机械通气序贯疗法