目的：观察速尿、洋地黄、可À明等常规利尿、强心和中枢兴奋药物的基础上联合无创双水平正压通气（BiPAP）治疗COPD合并左心衰竭肺水肿的临床效果。方法：回顾性分析我院2014年1月1日～2016年12月31日收治的COPD合并左心衰竭肺水肿的135例患者的临床资料，根据治疗方式的不同将患者分为观察组（n=68）和对照组（n=67）。其中，对照组患者采用速尿、洋地黄、可À明等常规利尿、强心和中枢兴奋药物进行治疗，观察组患者在对照组的基础上联合BiPAP治疗。比较两组患者治疗2 h后的一般临床指标以及治疗3个月后患者的治疗效果、心功能改善情况和肺功能改善情况。结果：治疗2h后，观察组患者的SBP、SDP、HR、PaO₂、PaCO₂、SaO₂水平和Brog呼吸困难评分均明显优于对照组。治疗3个月后，观察组患者的治疗总有效率为92.65%，明显高于对照组的79.10%；观察组患者的LVEF、6min步行距离和BNP水平等心功能指标均明显优于对照组；观察组患者的FEV₁、FEV₁/FVC和FEV₁%Pred等肺功能指标均明显优于对照组。结论：对于COPD合并左心衰竭肺水肿患者而言，在速尿、洋地黄、可À明等常规利尿、强心和中枢兴奋药物的基础上联合BiPAP治疗可迅速缓解患者的临床症状、改善患者的心肺功能，临床治疗效果显著。

Objective To observe the clinical effect of BIPAP of noninvasive ventilation in the treatment of COPD with left ventricular failure and pulmonary edema on the basis of conventional diuresis, cardiac and central excitatory drugs such as furosemide, digitalis and canola. Methods The clinical data of 135 patients with COPD complicated with left heart failure pulmonary edema from January 1, 2014 to December 31, 2016 in our hospital were retrospectively analyzed, and the patients were divided into observation group (n=68) and control group (n=67) according to different treatment methods. Among them, the control group was treated with furosemide, digitalis, canola and other conventional diuresis, cardiac and central excitatory drugs for treatment, while the observation group added BiPAP treatment based on the control. The general clinical indicators at 2 hours after the treatment, the treatment effect, cardiac function improvement and of lung function improvement at 3 months after the treatment of the two groups were compared. Results Two hours after the treatment, the levels of SBP, SDP, HR, PaO₂, PaCO₂, SaO₂ and Brog dyspnea score in the observation group were significantly better than those in the control group. Three months after the treatment, the total effective rate was 92.65% in the observation group, which was significantly higher than 79.10% in the control group; the cardiac parametersof LVEF, 6 min walking distance and BNP level in the observation group were significantly better than those in the control group, the lung function indexes of FEV₁, FEV₁/FVC and FEV₁% Pred in the observation group were significantly better than those in the control group. Conclusion For patients with COPD complicated with left heart failure and pulmonary edema, BiPAP treatment combined with conventional diuresis, cardiac and central excitatory drugs such as furosemide, digitalis and canola can significantly rapidlyrelieve the clinical symptoms of patients, improve the patient’s heart and lung function, and the treatment effect is better.