ObjectiveTo compare the clinical efficacy of tiotropium bromide versus ipratropium bromide when combined with non-invasive positive ventilation (NIPV) in the treatment of chronic obstructive pulmonary disease (COPD) patients with type Ⅱ respiratory failure. MethodsA total of 96 COPD patients with type Ⅱ respiratory failure were randomly divided into a control group or an observation group, with 48 cases in each group. Patients in both groups were treated conventionally, based on which the control group patients received a combined therapy of ipratropium bromide and NIPV, while the observation group patients received tiotropium bromide and NIPV. Both groups were treated for 2 weeks. The following were compared between the two groups, including the lung function and blood gas analysis indices levels before and after the treatment, the clinical efficacy after the treatment, and the occurrence of adverse reactions during the treatment. ResultsBefore the treatment, there was no statistically significant difference in the forced expiratory volume in one second (FEV1), FEV1 percentage of its predicted value, forced vital capacity (FVC), or FEV1/FVC between the two groups (all P＞0.05). After the 2-week treatment, the FEV1, FEV1 percentage of its predicted value, FVC, and FEV1/FVC in the observation group were higher than those in the control group (all P＜0.05). Before the treatment, there was no significant difference in the arterial partial pressure of oxygen (PaO2), PaO2/fraction of inspired oxygen (FiO2), and arterial partial pressure of carbon dioxide (PaCO2) between the two groups (all P＞0.05). After the 2-week treatment, the PaO2 and PaO2/FiO2 levels were higher and the PaCO2 level was lower in the observation group than those in the control group(all P＜0.05). The observation group patients had shorter time for using ventilators and hospital stay and a lower tracheal intubation rate as compared with the control group patients (all P＜0.05). No statistically significant difference was found in the mortality rate and the incidence of adverse reactions during the treatment between the two groups (all P＞0.05). ConclusionTiotropium bromide combined with NIPV therapy had superior clinical effect in the treatment of COPD complicated with type Ⅱ respiratory failure as compared with ipratropium bromide combined with NIPV, and it can improve patients′ lung function and dyspnea and shorten their time for using ventilators and hospital stay more effectively, with higher safety.

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