Comparison of the efficacy of sequential therapy with high-flow oxygen therapy versus non-invasive ventilation in the treatment of elderly COPD patients complicated with type II respiratory failure

doi:10.3877/cma.j.issn.2095-9133.2026.01.003

Abstract

Abstract:

Objective

To study the application of sequential treatment with high-flow oxygen therapy and noninvasive positive pressure ventilation in the treatment of elderly patients with chronic obstructive pulmonary disease (COPD) complicated with type Ⅱ respiratory failure.

Methods

A retrospective analysis was performed on the medical records of 84 elderly patients with COPD complicated with type Ⅱ respiratory failure admitted to Nanjing Drum Tower Hospital GroupSuqian Hospital from 2022 to 2024, including 40 males and 44 females. The patients were aged 60 to 73 years, with a mean age of (62.78 ± 6.83) years. According to the ventilation method, they were divided into three groups: ventilation group, oxygen therapy group, and combination group, with 28 cases in each group. The ventilation group received non-invasive positive pressure ventilation, the oxygen therapy group received high flow oxygen therapy, and the combination group received sequential non-invasive positive pressure ventilation with high flow oxygen therapy. Forty-eight hours after treatment, the clinical efficacy and the success rate of weaning from the ventilator were compared among the three groups; After 12 hours, 24 hours, 48 hours and 72 hours of treatment, the oxygenation index and respiratory rate were compared among the three groups.

Results

At 12, 24, 48, and 72 hours after treatment, the oxygenation index of the combination group was higher than that of the oxygen therapy group and the ventilation group, and the oxygen therapy group was higher than the ventilation group, with statistical significance (P<0.05). Before intervention, there was no statistically significant difference in respiratory rate indicators among the three groups (P>0.05). After intervention, the respiratory rate of the combination group was lower than that of the oxygen therapy group and the ventilation group, and the oxygen therapy group was lower than the ventilation group, with statistical significance (P<0.05). 48 hours after treatment, the success rate of weaning in the oxygen therapy group was 85.71% (24/28), the success rate of weaning in the combination group was 92.86% (26/28), and the weaning rate in the ventilation group was 64.29% (18/28). There was no statistically significant difference between the combination group and the oxygen therapy group, or between the oxygen therapy group and the ventilation group (P>0.05), but there was a statistically significant difference between the combination group and the ventilation group (P<0.05).

Conclusion

High-flow oxygen therapy is superior to noninvasive positive pressure ventilation treatment, but the sequential treatment with high-flow oxygen therapy and noninvasive positive pressure ventilation has more advantages in improving the oxygenation index, respiratory rate and the success rate of weaning from the ventilator.

Key words: Chronic obstructive pulmonary Disease, Respiratory failure, Elderly, High-flow oxygen therapy, Noninvasive ventilation, Weaning from the ventilator

Shuang Jiang, Dongyan Shi. Comparison of the efficacy of sequential therapy with high-flow oxygen therapy versus non-invasive ventilation in the treatment of elderly COPD patients complicated with type II respiratory failure[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2026, 12(01): 10-15.

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Figures/Tables 5

References 16

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组别	例数	性别		年龄[岁，例（%）]	COPD病程[年，例（%）]	合并症			吸烟
组别	例数	男性	女性	年龄[岁，例（%）]	COPD病程[年，例（%）]	高血压	冠心病	糖尿病	是	否
通气组	28	15（53.57）	13（46.43）	62.81±6.22	10.15±2.56	14（50.00）	12（42.86）	16（57.14）	20（71.43）	8（28.57）
氧疗组	28	12（42.86）	16（57.14）	63.17±7.32	9.86±2.55	16（57.14）	11（39.29）	17（60.71）	19（67.86）	9（32.14）
联合组	28	13（46.43）	15（53.57）	62.36±6.59	10.06±2.63	15（53.57）	13（46.43）	19（67.86）	17（60.71）	11（39.29）
χ²/t值		0.67		0.10	0.53	0.09	0.29	0.71	0.75
P值		>0.05		>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	性别		年龄[岁，例（%）]	COPD病程[年，例（%）]	合并症			吸烟
组别	例数	男性	女性	年龄[岁，例（%）]	COPD病程[年，例（%）]	高血压	冠心病	糖尿病	是	否
通气组	28	15（53.57）	13（46.43）	62.81±6.22	10.15±2.56	14（50.00）	12（42.86）	16（57.14）	20（71.43）	8（28.57）
氧疗组	28	12（42.86）	16（57.14）	63.17±7.32	9.86±2.55	16（57.14）	11（39.29）	17（60.71）	19（67.86）	9（32.14）
联合组	28	13（46.43）	15（53.57）	62.36±6.59	10.06±2.63	15（53.57）	13（46.43）	19（67.86）	17（60.71）	11（39.29）
χ²/t值		0.67		0.10	0.53	0.09	0.29	0.71	0.75
P值		>0.05		>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	PaCO₂
组别	例数	治疗前	拔管前	拔管后2 h	拔管后12 h	拔管后24 h	拔管后48 h	F值	P值
氧疗组	28	58.96±9.76	39.45±2.13^a	38.13±2.69^a	40.19±2.24^a	39.31±2.14^a	36.95±2.23^a
联合组	28	58.62±9.65	39.23±2.68^a	37.25±2.45^a	38.25±2.89^a	38.23±2.11^a	35.98±2.16^a	3.91	<0.05
通气组	28	59.93±9.74	40.90±2.47^a	39.44±2.13^a	39.16±2.51^a	38.09±2.63^a	38.63±2.51^a
F值		4.22
P值		<0.05
组别	例数	PaO₂
组别	例数	治疗前	拔管前	拔管后2 h	拔管后12 h	拔管后24 h	拔管后48 h	F值	P值
氧疗组	28	58.93±2.13	84.95±4.59^a	78.32±12.62^a	76.21±3.89^a	77.86±2.16^a	82.26±3.85^a
联合组	28	57.93±2.51	90.65±4.89^a	76.53±14.85^a	77.12±4.13^a	78.12±1.92^a	83.10±3.74^a	3.13	<0.05
通气组	28	57.23±12.21	95.76±1.65^a	76.09±4.23^a	74.32±3.61^a	75.82±2.46^a	80.81±3.71^a
F值		4.03
P值		<0.05

组别	例数	PaCO₂
组别	例数	治疗前	拔管前	拔管后2 h	拔管后12 h	拔管后24 h	拔管后48 h	F值	P值
氧疗组	28	58.96±9.76	39.45±2.13^a	38.13±2.69^a	40.19±2.24^a	39.31±2.14^a	36.95±2.23^a
联合组	28	58.62±9.65	39.23±2.68^a	37.25±2.45^a	38.25±2.89^a	38.23±2.11^a	35.98±2.16^a	3.91	<0.05
通气组	28	59.93±9.74	40.90±2.47^a	39.44±2.13^a	39.16±2.51^a	38.09±2.63^a	38.63±2.51^a
F值		4.22
P值		<0.05
组别	例数	PaO₂
组别	例数	治疗前	拔管前	拔管后2 h	拔管后12 h	拔管后24 h	拔管后48 h	F值	P值
氧疗组	28	58.93±2.13	84.95±4.59^a	78.32±12.62^a	76.21±3.89^a	77.86±2.16^a	82.26±3.85^a
联合组	28	57.93±2.51	90.65±4.89^a	76.53±14.85^a	77.12±4.13^a	78.12±1.92^a	83.10±3.74^a	3.13	<0.05
通气组	28	57.23±12.21	95.76±1.65^a	76.09±4.23^a	74.32±3.61^a	75.82±2.46^a	80.81±3.71^a
F值		4.03
P值		<0.05

组别	例数	显效	有效	无效
通气组	28	18（64.29）	8（28.57）	2（7.14）
氧疗组	28	20（71.43）	6（21.43）	2（7.14）
联合组	28	19（67.86）	6（21.43）	3（10.71）
Hc值		0.28
P值		>0.05

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