Objective:TTo observe the clinical efficacy of noninvasive positive pressure ventilation(NIPPV)for AECOPD with respiratory failure and disturbance of consciousness.Methods:A total of 58 AECOPD patients with respiratory failure and consciousness in our hospital from 2011 July to August 2015 were randomly divided into NIPPV group and control group. The control group was received conventional therapy, and NIPPV was added to the NIPPV group. The heart rate(HR), respiratory rate(RR), Glasgow coma score(GCS) and blood gas analysis of patients before and after 24 h, 72 h of treatment, and the adverse reactions in NIPPV group were observed.Results: The PaCO2, RR, HR at 24 h and 72 h were significantly lower and PaO2 and GCS were significantly increased in NIPPV group. Compared to the control group, PaO2, PaCO2, HR and GCS after 24 h and 72 h were different (t=11.29,t=9.19,t=9.21,t=11.23,t=10.30,t=7.28, t=10.34,t=6.69;P<0.05) . NIPPV group had a higher cure rate and relatively low rate of endotracheal intubation than the control group. The differences are statistically significant(x2=10.07,x2=8.32,P<0.05). The hospital mortality is lower than the control group and there is no statistically significant(x2=3.50,P>0.05). Some patients in NIPPV group had initial discomfort, facial skin hyperemia erosion, mild gastrointestinal discomfort and fear, which were improved after symptomatic treatment.Conclusion: NIPPV treatment for AECOPD patients with respiratory failure and disturbance of consciousness which can effectively correct respiratory acidosis and CO2 retention. The spontaneous breathing and arterial oxygen level of patient can be gradually recovered, which are better than the conventional treatment.