Acute exacerbation of chronic obstructive pulmonary disease (COPD) is an important part of the course of COPD. Patients with life-threatening acute exacerbation need to be admitted to the respiratory intensive care unit (RICU) for treatment in time. Malnutrition is common in COPD patients, and nutritional risk also has a high prevalence in patients with COPD exacerbation, which is closely associated with the clinical outcome and mortality of these patients. Identifying patients with high nutritional risk and providing appropriate nutritional treatment will help to improve survival rate, shorten length of hospital stay and reduce complications. This review describes the potential mechanisms of malnutrition in patients with COPD, the nutritional risk assessment of patients with COPD exacerbation hospitalized in RICU, the selection of nutritional treatment methods and formulas, and the relevant problems of nutritional management of patients required noninvasive ventilation, hoping to provide information for the optimization of nutritional treatment strategy for acute exacerbation of COPD and the exploration of clinical research in the future.慢性阻塞性肺疾病(慢阻肺)急性加重是慢阻肺病程中的重要组成部分,危及生命的急性加重患者需要及时收住呼吸重症监护病房(RICU)进行救治。营养不良在慢阻肺患者中普遍存在,营养风险在慢阻肺急性加重的患者亦有较高的发生率,与患者的临床结局及病死率密切相关。甄别营养风险增高的患者并给予适当的营养治疗和管理,有助于提高生存率、缩短住院时间、减少并发症。本文将阐述慢阻肺患者发生营养不良的机制、慢阻肺急性加重RICU住院患者的营养风险评估、营养治疗方式和配方的选择、无创通气患者营养管理的相关问题等,希望对慢阻肺急性加重营养治疗策略的优化以及未来临床研究的探索提供帮助。.