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【目的】探讨气管插管‐肺表面活性物质‐拔管（InSurE）技术在早产儿呼吸支持中的临床应用价值。【方法】回顾性分析本院新生儿重症监护室2011年6月至2013年6月收治的胎龄≤32周有呼吸困难且需要呼吸支持的早产儿临床资料，依据呼吸支持方法的不同分为InSurE组与机械通气（M V ）组。比较两组患儿治疗后1 h、24 h动脉血气改善情况，呼吸机相关性肺炎（VAP）、气漏、肺出血、支气管肺发育不良（BPD）、早产儿脑室周‐脑室内出血（PIVH）、早产儿视网膜病（ROP）等疾病的发生情况，以及呼吸机使用时间、用氧时间、住院时间等。【结果】①共75例纳入研究，其中33例为 InSurE组，42例为 M V组。②组内治疗前后氧合通气情况比较：两组患儿治疗后1 h动脉氧分压均比治疗前高[InSurE组为（63．15±6．09）mmHg比（49．54±6．9）mmHg ，MV组为（66．21±7．31）mmHg比（51．29±7．05）mmHg]差异均有统计学意义（均 P ＜0．05）。两组患儿治疗后1 h动脉二氧化碳分压均比治疗前低，InSurE组为（46．06±5．05）mmHg 比（52．03±5．17）mmHg ，MV 组为（43．69±7．84）mmHg比（52．57 ± 6．39）mmHg ，差异均有统计学意义（均 P ＜0．05）。③组间氧合通气情况比较：InSurE组与M V组治疗后1 h、24h动脉血氧分压、二氧化碳分压相比差异无统计学意义（均 P ＞0．05）。④组间疾病发生情况比较：In‐SurE组患儿VAP、中度以上BPD和PIVH的发生率分别为0％（0／33）、24．2％（8／33）、24．2％（8／33），均低于MV组[分别为11．9％（5／42）、47．6％（20／42）、52．4％（22／42）]，差异均有统计学意义（均 P ＜0．05）。⑤InSurE组患儿呼吸机使用时间、用氧时间、住院时间分别为7（3～13） d、34（30～39） d和44（37～52）d ，短于M V组[分别为13（8～20） d、42（34～49） d和50（42～60）d]，差异均有统计学意义（均 P ＜0．05）。【结论】 InSurE技术在早产儿呼吸支持应用中并发症少、用氧时间及住院时间短、安全性高，值得推广应用。“,”[Objective] To explore the clinical value of intubation‐surfactant‐extubation (InSurE) technology for respiratory sup‐ports of premature infants .[Methods] From June 2011 to June 2013 ,gestational age less than or equal to 32 weeks premature infants were recruited .Arteria1 blood gases at 1 hour and 24 hour after treatment were compared between two groups .The incidence of venti‐lator‐associated pneumonia (VAP ) ,air 1eaking ,pulmonary hemorrhage ,bronchopulmonary dysplasia (BPD) ,periventricular‐intraven‐tricular hemorrhage (PIVH) and retinopathy of prematurity (ROP) were compared with Chi‐square test .Duration of ventilation ,oxy‐gen inhalation and hospital stay were compared by rank‐sum test .[Results]A total of 75 neonates were recruited and divided into In‐SurE ( n=33) and mechanical ventilation (MV) ( n =42) groups .PO2 levels were higher in InSurE group after 1‐hour treatment than those before treatment [(63 .15 ± 6 .09) mmHg vs (49 .54 ± 6 .9) mmHg ,P<0 .05] while PaCO2 was lower [(46 .06 ± 5 .05) vs (52 .03 ± 5 .17) mmHg ,P<0 .05] .PaO2 levels in MV group after 1‐hour treatment were higher than those before treatment [(66 .21 ± 7 .31) vs (51 .29 ± 7 .05) mmHg ,P<0 .05] while PaCO2 was lower [(43 .69 ± 7 .84) vs (52 .57 ± 6 .39) mmHg ,P<0 .05] .No inter‐group differences existed in PO2 and PaCO2 after 1‐hour and 24‐hour treatments ( P<0 .05) .The incidence of VAP ,moderate or above BPD and PIVH were lower in InSurE group than those in MV group [0 % (0/33) ,24 .2% (8/33) & 24 .2% (8/33) vs 11 .9% (5/42) ,47 .6% (20/42)& 52 .4% (22/42)] ( P<0 .05 respectively) .Duration of ventilation ,oxygen inhalation and dura‐tion of hospital stays in InSurE group were all shorter than those of MV group [7(3~13) ,34 (30~39) & 44(37~52) vs 13(8~20) ,42(34~49)& 50(42~60) days] ( P<0 .05 respectively) .[Conclusions] InSurE tcchnology may be used in premature infants due to fewer complications ,greater safety ,lowered oxygen inhalation and shorter hospital stays .And it is worthy wider popularization .