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目的:分析吸入布地奈德联合经鼻高流量湿化氧疗(HFNC)在急性加重期慢性阻塞性肺疾病(AECOPD)脱机困难患者的应用效果。方法:选择平煤神马医疗集团总医院2017年2月至2019年2月诊治的82例AECOPD脱机困难患者，按照随机数字表分为两组，每组41例，全部患者均接受常规治疗，包括补液、氧疗、营养支持、纠正内环境紊乱等，同时给予患者抗感染治疗，在此基础上为患者使用布地奈德雾化吸入，并给予其氧疗，对照组接受常规经鼻低流量氧疗，研究组接受HFNC，连续治疗7 d后评价治疗效果，记录并对比两组各症状体征缓解时间及住院时间；分别于治疗前、治疗结束时，检测并对比两组血气分析指标与肺功能。结果:两组一般资料比较差异未见统计学意义(n P>0.05)；研究组临床有效率、撤机成功率均高于对照组，呼吸困难、咳嗽等症状缓解时间短于对照组，每日吸痰次数少于对照组，住院时间短于对照组(n P<0.05)；治疗结束时，研究组呼吸频率(RR)较对照组降低，动脉氧分压(PaOn 2)水平较对照组升高，动脉二氧化碳分压(PaCOn 2)水平较对照组降低(n P<0.05)；治疗结束时，研究组第一秒用力呼气容积(FEV1)、FEV1占预计值百分比(FEV1%)、FEV1/用力肺活量(FEV1/FVC)水平均高于对照组(n P0.05); the clinical effective rate and success rate of weaning in research group were higher than those in control group, while the relief time of dyspnea and cough in research group was shorter than that in control group, the number of daily sputum aspiration in research group was less than that in control group, and the hospital stays in research group were shorter than those in control group (n P<0.05); at the end of treatment, the respiratory rate (RR) in research group was lower than that in control group, the arterial partial pressure of oxygen (PaOn 2) in research group was higher than that in control group, and the partial pressure of carbon dioxide in arterial blood (PaCOn 2) in research group was lower than that in control group (n P<0.05); at the end of treatment, the forced expiratory volume in one second (FEV1), one second to forced vital capacity ratio (FEV1%), first second expiratory volume/forced vital capacity (FEV1/FVC) in rese arch group were higher than those in control group (n P<0.05).n Conclusions:Inhaled budesonide combined with humidified high-flow nasal cannula oxygenation in treatment of AECOPD patients with difficult weaning is effective, it can quickly improve clinical symptoms and signs, improve blood gas indexes, enhance pulmonary function, and promote weaning.