Objective To explore the risk factors related to re-intubation of invasive and noninvasive sequential mechanical ventilation of acute exacerbation of chronic obstructive pulmonary disease(AECOPD). Methods The clinical data of 139 cases of AECOPD receiving invasive and noninvasive sequential mechan-ical ventilation in Intensive Care Unit of Qinzhou City Second People′s Hospital from Jan.2012 to Jun.2014 were analyzed retrospectively,and the 139 cases were divided into re-intubation group (19 cases) and non re-intubation group(120 cases),and the risk factors related to re-intubation were analyzed.Results Poor capability of sputum exclusion(OR =4.987,95%CI 1.813-11.052,P =0.003),CO2 partial pressure increase after 12 h with sequential noninvasive mechanical ventilation(OR=7.563,95%CI 1.936-19.857, P=0.001 ) were the independent risk factors for re-intubation.Conclusion Poor capability of sputum exclusion and CO2 partial pressure increase after 12 h with sequential noninvasive mechanical ventilation are risk factors for re-intubation of AECOPD patients undergoing invasive and noninvasive sequential mechanical ventilation.%目的：探讨慢性阻塞性肺疾病急性加重期（ AECOPD）合并呼吸衰竭患者有创－无创序贯通气撤机时再次气管插管（再插管）的相关因素。方法回顾性分析2012年1月至2014年6月钦州市第二人民医院ICU收治的AECOPD合并呼吸衰竭行有创－无创序贯通气撤机患者的临床资料，根据患者是否需要再次插管分为再插管组（19例）和非再次插管组（120例），对可能引起再次插管的危险因素进行分析。结果咳嗽排痰能力差（ OR ＝4．987，95％CI 1．813～11．052，P ＝0．003）、无创序贯通气12 h时二氧化碳分压升高（OR＝7．563，95％CI 1．936～19．857，P＝0．001）是导致AECOPD合并呼吸衰竭患者行有创－无创序贯通气撤机时再插管的影响因素。结论咳嗽排痰能力差和无创序贯通气12 h时二氧化碳分压升高是AECOPD合并呼吸衰竭患者行有创－无创序贯通气撤机时再次插管的危险因素。
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