探讨经鼻高流量氧疗（HFNC）联合高压力无创正压通气（NPPV）治疗慢性阻塞性肺疾病急性加重（AECOPD）合并Ⅱ型呼吸衰竭患者的效果。

回顾性分析2022年1月至2025年1月被宜兴市第六人民医院呼吸内科收治的90例AECOPD合并Ⅱ型呼吸衰竭患者临床资料，其中男性47例，女性43例；年龄24~69岁[（46.82±7.61）岁]。按照治疗方式分为对照组和观察组，每组各45例，对照组给予高压力NPPV治疗，观察组给予HFNC联合高压力NPPV治疗。对比分析两组患者入院时及治疗3 d后的炎症因子[C反应蛋白（CRP）、白介素-17（IL-17）、肿瘤坏死因子-α（TNF-α）]、肺功能指标[用力肺活量（FVC）、第一秒用力呼气容积（FEVl）、FEVl/FVC]、血气分析指标[动脉血氧分压（PaO₂）、二氧化碳（PaCO₂）、血液酸碱度（pH值）]水平变化，比较两组患者住院天数、插管率、随访28 d后再入院率及治疗效果。

入院时，两组患者炎症因子CRP、IL-17、TNF-α比较差异无统计学意义（P>0.05）；治疗3 d后，两组患者的CRP、IL-17、TNF-α水平均降低，观察组炎症因子CRP、IL-17、TNF-α均低于对照组（P<0.05）。入院时，两组患者肺功能指标FVC、FEV1、FEV1/FVC比较差异无统计学意义（P>0.05）；治疗3 d后，两组患者的FVC、FEV1、FEV1/FVC均升高，观察组肺功能指标FVC、FEV1、FEV1/FVC均高于对照组（P<0.05）。入院时，两组患者血气分析指标PaO₂、PaCO₂、pH值比较差异无统计学意义（P>0.05）；治疗3 d后，两组患者的PaO₂、pH值均明显升高，PaCO₂明显降低，观察组血气分析指标PaO₂、pH值均高于对照组，PaCO₂则低于对照组（P<0.05）。观察组住院天数、插管率、随访28 d后再入院率均短于或低于对照组（P<0.05）。观察组临床治疗总有效率高于对照组（P<0.05）。

HFNC联合高压力NPPV对AECOPD合并Ⅱ型呼吸衰竭患者开展治疗，能有效改善患者肺功能指标、血气分析指标，减轻患者炎症反应，治疗效果好，值得推广。

To explore effects of nasal high flow oxygen therapy (HFNC) combined with high-pressure non-invasive positive pressure ventilation (NPPV) on inflammatory factors and lung function in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and type II respiratory failure.

A retrospective analysis was conducted on the treatment of 90 patients with AECOPD combined with type II respiratory failure admitted to the Respiratory Department of Yixing Sixth People's Hospital from January 2022 to January 2025, among them, there were 47 males and 43 females; their ages ranged from 24 to 69 years, with an average of (46.82±7.61) years. The patients were divided into a control group and an observation group, with 45 patients in each group. The control group received high-pressure NPPV treatment, while the observation group received HFNC combined with high-pressure NPPV treatment. Comparative analysis of inflammatory factors [(C-reactive protein, CRP), (interleukin-17, IL-17), (tumor necrosis factor-α, TNF-α)], pulmonary function indicators [(forced vital capacity, FVC), (forced expiratory volume in the first second, FEV1), FEV1/FVC], and blood gas analysis indicators [(partial pressure of oxygen, PaO₂), (partial pressure of carbon dioxide, PaCO₂), pH] between two groups of patients upon admission and 3 days after treatment. The changes of CO₂ and blood pH levels between the two groups, including length of hospital stay, intubation rate, readmission rate after 28 days of follow-up, and treatment efficacy were compared.

At admission, there was no significant difference in the levels of inflammatory factors CRP, IL-17, and TNF-α between the two groups (P>0.05); after 3 days of treatment, the CRP, IL-17, and TNF-α decreased in both groups of patients, the inflammatory factors CRP, IL-17, and TNF-α in the observation group were lower than those in the control group (P<0.05). At admission, there was no significant difference in the lung function indicators FVC, FEV1, and FEV1/FVC between the two groups (P>0.05); after 3 days of treatment, the FVC, FEV1, and FEV1/FVC of both groups of patients increased,and the lung function indicators FVC, FEV1, and FEV1/FVC in the observation group were higher than those in the control group (P<0.05). At admission, there was no significant difference in the blood gas analysis indicators PaO₂, PaCO₂, and pH value between the two groups (P>0.05); after 3 days of treatment, the PaO₂ and pH values of both groups of patients increased significantly, while the PaCO₂ values decreased significantly,the blood gas analysis indicators PaO₂ and pH value in the observation group were higher than those in the control group, while PaCO₂ was lower than that in the control group (P<0.05). The observation group had lower hospitalization days, intubation rate, and readmission rate due to the disease after 28 days of follow-up compared to the control group (P<0.05). The total effective rate of clinical treatment in the observation group was higher than that in the control group (P<0.05).

The combination of HFNC and high-pressure NPPV in the treatment of AECOPD patients with type II respiratory failure can effectively improve lung function indicators, blood gas analysis indicators, reduce inflammatory reactions, and has good therapeutic effects, which is worth promoting.