To evaluate the clinical efficacy and safety of bi-level positive airway pressure (BiPAP) noninvasive mechanical ventilation in the treatment of patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with type Ⅱ respiratory failure.

The clinical data of 378 patients with AECOPD combined with type Ⅱ respiratory failure who were hospitalized from January 2015 to June 2018 in our Department of Respiratory Medicine were reviewed. They were divided into observation group 198 cases and control group 180 cases according to treatment methods. The control group received conventional treatment, and the observation group received non-invasive mechanical ventilation with oral nasal mask BiPAP based on the treatment of the control group. Blood gas analysis indicators, clinical remissions, and adverse reactions were recorded before treatment, 2 hours, and 24 hours after treatment, and the differences between groups were compared.

After 2 hours of treatment, the patients in the observation group had significant improvements in pH, oxygenation index (PaO₂/FiO₂), PaO₂, and lactic acid levels (P<0.05), while the control group had no significant improvement (P>0.05). After 24 hours of treatment, the pH, PaO₂/FiO₂, PaO₂, and lactic acid levels of the two groups of patients improved significantly, and the patients in the observation group improved more significantly than those in the control group (P<0.05). There was no significant difference in the clinical response rate between the two groups after 3 days of treatment (χ²=1.042, P=0.307). The clinical response rate of the observation group was significantly higher than that of the control group at 5 and 7 days after treatment (P<0.05). There was no significant difference in the incidence of flatulence, oropharyngeal ulcers, and oral fungi in the two groups (P>0.05). The incidence of pulmonary encephalopathy (3.03% vs. 10.0%, P=0.006) and tracheal intubation rate (7.57% vs. 11.11%, P=0.033) in the observation group were significantly lower than those in the control group; the reasonable use of noninvasive ventilator can effectively reduce the average hospitalization day and medical expenses of patients.

Oral and nasal mask BiPAP noninvasive mechanical ventilation is an effective treatment for AECOPD combined with type Ⅱ respiratory failure, and it is worthy of clinical application.