目的：研究呼气末二氧化碳分压（PetCO₂）测定用于监测重度呼吸性酸中毒的慢性阻塞性肺疾病（COPD）患者接受无创正压通气（NPPV）治疗中呼吸不良事件的临床价值。方法：选择我院收治的重度呼吸性酸中毒的COPD患者60例，予NPPV治疗，同时行心电、脉搏氧饱和度（SpO₂）和PetCO₂监测，观察和比较患者初始治疗2 h内不同监测手段发现呼吸不良事件的发生情况。结果：NPPV初始治疗2 h内无死亡病例，共发现呼吸不良事件168次，通气不足、通气过度、窒息和低氧血症分别为57例、37例、34例和40例。与心电及SpO₂监测相比，PetCO₂在监测通气不足、通气过度、窒息和低氧血症及总的不良事件方面明显更优（P<0.05）。60例重度呼吸性酸中毒COPD患者NPPV治疗有效52例，有效率86.67%。结论：在接受NPPV治疗的重度呼吸性酸中毒COPD患者监测中，与常规心电及SpO₂监测相比，PetCO₂对呼吸不良事件具有更高的监测发现价值。

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