目的:研究肺表面活性物质(PS)联合俯卧位机械通气(PPV)治疗新生儿呼吸窘迫综合征(NRDS)的临床疗效。方法:将收入我院行机械通气的NRDS患儿分成三组,治疗1组采用PS联合PPV,治疗2组仅采用PPV,对照组仅采用仰卧位机械通气,三组患儿其他治疗方法相同。采用多功能监护仪监护,分别在机械通气前、机械通气30 min、机械通气6 h、机械通气24 h监测患儿血气分析指标,了解患儿动脉血PaO2、PaCO2,以及各阶段呼吸机的平均气道压(MAP)、吸入氧浓度(FiO2)、氧合指数(OI),详细记录患儿用机时间、平均住院日、并发症呼吸机相关性肺炎(VAP)和呼吸机相关性肺损伤(VILI)以及预后情况。结果:三组患儿治疗前后各阶段血气分析、呼吸机指数比较差异有统计学意义(P<0.05);治疗1组与对照组治疗后各阶段血气分析、呼吸机指数比较差异均有用统计学意义(P<0.01);治疗2组与对照组治疗24 h后血气分析、呼吸机指数比较差异均有统计学意义(P<0.05),治疗24 h内差异无统计学意义(P>0.05);治疗2组和对照组用机时间、平均住院日、并发症VAP和VILI比较差异有统计学意义(P<0.05);治疗1组与对照组用机时间、平均住院日、并发症VAP和VILI比较差异有统计学意义(P<0.01)。结论:机械通气能有效治疗NRDS,PPV优于仰卧位机械通气,PS联合PPV治疗NRDS能有效缩短呼吸机使用时间,减少机械通气并发症,提高NRDS患儿的存活率,改善预后。 Objective: To investigate the clinical effect of pulmonary surfactant (PS) combined with prone position mechanical ventilation (PPV) on neonatal respiratory distress syndrome (NRDS). Methods: NRDS children who received mechanical ventilation in our hospital were divided into three groups. Treatment group 1 was PS combined with PPV. Treatment group 2 only used PPV. Control group only used supine position mechanical ventilation. The other treatment methods were the same in the three groups. Multi-function monitor was used to monitor the blood gas analysis indexes before mechanical ventilation, mechanical ventilation for 30 min, mechanical ventilation for 6 h and mechanical ventilation for 24 h to understand the PaO2 and PaCO2 in arterial blood of children and the mean of ventilator in each stage Airway pressure (MAP), FiO2 and OI were recorded, and the time spent on children, average length of stay, complication, ventilator-associated pneumonia and ventilator-associated lung injury were recorded. (VILI) and prognosis. Results: There were significant differences in blood gas analysis and respirator index between the three groups before and after treatment (P <0.05). The differences of blood gas analysis and respirator index between treatment group 1 and control group were statistically significant (P <0.01). There was significant difference between the two groups in blood gas analysis and ventilator index (P <0.05) after treatment for 24 h, there was no significant difference within 24 h after treatment (P> 0.05) ; Treatment 2 and control group machine time, average length of stay, complications VAP and VILI difference was statistically significant (P <0.05); treatment group 1 and control group with machine time, average length of stay, complications VAP and VILI difference was statistically significant (P <0.01). CONCLUSION: Mechanical ventilation can effectively treat NRDS, PPV is superior to supine position mechanical ventilation. PS and PPV treatment of NRDS can shorten the time of ventilator, reduce the mechanical ventilation complications, improve the survival rate of NRDS children and improve the prognosis.