【摘要】 目的 探讨有创-无创序贯通气治疗慢性阻塞性肺疾病急性加重期（AECOPD）合并Ⅱ型呼吸衰竭的临床效果。方法选取2023年1～12月我院呼吸科收治的60例AECOPD合并Ⅱ型呼吸衰竭患者为研究对象，按随机数字表法分为对照组和观察组，每组30例。对照组在基础治疗上予以有创通气治疗，观察组在基础治疗上予以有创-无创序贯通气治疗，比较两组患者治疗前、治疗48 h后的生理指标变化、治疗时间以及机械通气相关并发症发生情况。结果 治疗48 h后，两组患者的呼吸频率（RR）、心率（HR）、氧合指数（PO₂/FiO₂）、肺泡-动脉氧分压差（A-aDO₂）、血酸碱值（pH）、二氧化碳分压（PaCO₂）均较治疗前改善（均P<0.05），而两组的各指标比较差异均无统计学意义（均P>0.05）。观察组的总通气时间、有创通气时间、ICU住院时间均短于对照组，差异均有统计学意义（均P<0.05）。观察组的机械通气相关并发症发生率为13.33%，低于对照组的36.66%，组间比较差异有统计学意义（P<0.05）。结论 有创-无创序贯通气治疗AECOPD合并Ⅱ型呼吸衰竭患者的疗效确切，能有效促进各项生理指标恢复，缩短治疗时间，降低机械通气相关并发症的发生风险。更多还原

【Abstract】 Objective To investigate the clinical efficacy of invasive-noninvasive sequential ventilation in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD） complicated with type Ⅱ respiratory failure. Methods Sixty patients with AECOPD complicated with type Ⅱ respiratory failure who were admitted to the respiratory department of our hospital from January to December 2023 were selected as the research subjects. They were divided into a control group and an observation group according to the random number table method,with 30 patients in each group. The control group received invasive ventilation treatment on the basis of basic treatment,while the observation group received invasive-noninvasive sequential ventilation treatment on the basis of basic treatment. The changes in physiological indicators before and 48 hours after treatment,treatment duration,and the occurrence of mechanical ventilation-related complications were compared between the two groups. Results Forty-eight hours after treatment,the respiratory rate（RR）,heart rate（HR）,oxygenation index（PO₂/FiO₂）,alveolar-arterial oxygen partial pressure difference（A-aDO₂）,blood p H value,and partial pressure of carbon dioxide（PaCO₂） of both groups were improved compared with those before treatment（all P<0.05）. However,there were no statistically significant differences in these indicators between the two groups（all P>0.05）. The total ventilation time,invasive ventilation time,and length of stay in the intensive care unit（ICU） of the observation group were shorter than those of the control group,and the differences were statistically significant（all P<0.05）. The incidence of mechanical ventilation-related complications in the observation group was 13.33%, which was lower than 36.66% in the control group. The difference between the two groups was statistically significant（P<0.05）. Conclusion Invasive-noninvasive sequential ventilation has a definite therapeutic effect in the treatment of AECOPD patients complicated with type Ⅱ respiratory failure. It can effectively promote the recovery of various physiological indicators,shorten the treatment time,and reduce the risk of mechanical ventilation-related complications.更多还原