A male, 70 years old, with recurrent active shortness of breath for more than 10 years, aggravated with wheezing for more than 2 years. Diagnosis: 1, chronic obstructive pulmonary emphysema, type 2 respiratory failure, multiple pulmonary blisters in the right lung, giant pulmonary blister formation, and pulmonary blister in the left lower lung; 2, coronary artery disease; 3, hypertension. On admission, the patient was in severe respiratory distress and had to stop to rest and catch his breath when walking 3-5 m. Pulmonary function tests: extremely severe mixed ventilation distress, FEV1: 0.66 L; FEV1/FVC: 30%. Finger end SPO2: 85%, arterial blood gas PCO2: 66.8 mmHg; PO2: 52.8 mmHg. thoracoscopic right lung decompression surgery was performed on July 8, 2015, with minimally invasive resection of the right pulmonary alveolus, and tracheal intubation was removed on the same day and chest drainage tube was removed the next day. Postoperatively, dyspnea improved significantly, and he walked 100 meters on his own without rest, without shortness of breath. Finger end SPO2: 90%; arterial blood gas PCO2: 44.1 mmHg; PO2: 55.8 mmHg. He was discharged from the hospital on July 17.