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目的 探讨肺表面活性物质(pulmonary surfactant,PS)微创给药(less invasive surfactant administration,LISA)和传统插管-给药-拔管(intubate surfactant extubate,INSURE)技术在早产儿呼吸窘迫综合征(respiratory distress syndrome,RDS)治疗中的效果.方法 选择2017年1月至2018年12月北京大学第一医院新生儿重症监护病房收治、胎龄≤32周、需应用PS的RDS早产儿进行前瞻性研究,随机分为LISA组和INSURE组,对比两组应用呼吸机或鼻导管吸氧的时间、给药过程中的不良反应、首次PS治疗结局和并发症发生率等.结果 共纳入67例,LISA组34例,INSURE组33例,两组患儿生后72 h内机械通气率、吸氧时间、肺出血或气胸、支气管肺发育不良、坏死性小肠结肠炎、3～4度脑室周围脑室内出血、脑室旁白质软化发生率及死亡率比较,差异均无统计学意义(P＞0.05).LISA组应用无创呼吸机时间长于INSURE组[(10.5 ±8.7)d比(7.1±2.6)d],PS反流率高于INSURE组[41.2％ (14/34)比18.2％ (6/33)],差异均有统计学意义(P＜0.05).结论 LISA技术和INSURE技术治疗胎龄≤32周RDS早产儿的效果和并发症发生率相当,但LISA技术发生PS反流的风险相对较高,撤离呼吸机时间相对较晚.“,”Objective To compare the short-term outcomes of less invasive surfactant administration (LISA) with traditional intubate-surfactant-extubate (INSURE) method for respiratory distress syndrome (RDS) in premature infants.Method From January 2017 to December 2018,premature infants (gestational age ≤32 weeks) diagnosed with RDS who needed pulmonary surfactant (PS) administration were prospectively enrolled and randomly assigned into LISA group and INSURE group.The duration of oxygen supply,side effects during PS administration,the outcome and severe adverse events,bronchopulmonary dysplasia (BPD),necrotizing enterocolitis (NEC),3 ～ 4° periventricular intraventricular hemorrhage (PIVH),periventricular leukomalacia (PVL) and death were compared.Result A total of 67 cases were enrolled including 34 in LISA group and 33 in INSURE group.No significant differences existed between the two group on mechanical ventilation rates,oxygen therapy duration and the incidences of severe adverse events.However,the duration of noninvasive ventilation in LISA group was significantly longer than INSURE group [(10.5 ± 8.7) d vs.(7.1 ± 2.6) d,P ＜ 0.05].The LISA group had significantly higher PS reflux rate than INSURE group [41.2％ (14/34)vs.18.2％ (6/33),P ＜0.05].Conclusion LISA has similar clinical effects and severe adverse events as INSURE,but with higher rates of PS reflux and longer duration of noninvasive ventilation.