Abstract: OBJECTIVE To investigate the clinical effect of fiberoptic bronchoscopy combined with naloxone in the treatment of elderly patients with severe respiratory failure and the improvement of blood gas and pulmonary function. METHODS Sixty-nine elderly patients with chronic obstructive pulmonary disease(COPD) accompanied by severe respiratory failure who were treated in Liaoyou Baoshihua Hospital from May 2016 to April 2018 were selected as the study subjects. They were divided into experimental group and control group by random number table method. The control group was treated with conventional tracheal intubation mechanical ventilation, and the experimental group was treated with fiberoptic bronchoscopy combined with naloxone. The therapeutic effects of the two groups and the improvement of blood gas parameters and lung function were compared between the two groups. RESULTS Before treatment, there was no significant difference in the results of pulmonary function index and thoracic and pulmonary compliance index between the two groups. After treatment, the results of pulmonary function index and thoracic and pulmonary compliance index of the two groups were significantly improved, and the improvement of the experimental group was significantly better than that of the control group(P<0.05). The results of blood gas related indicators after treatment showed that the respiratory rate and p(CO₂) level in the experimental group were significantly lower than those in the control group(P<0.05); there was no significant difference in pH level; SaO₂ and p(O₂) levels were significantly higher than the control group(P<0.05). The overall hospitalization time of the experimental group was significantly shorter than that of the control group(P<0.05); the mortality and complication rate were significantly lower than the control group(P<0.05). CONCLUSION Fiberoptic bronchoscopy combined with naloxone is effective in the treatment of elderly patients with severe respiratory failure. It can rapidly improve the lung ventilation function and blood gas index, reduce the risk of lung infection, and has high safety. It is worthy of popularization and application.