Objective To investigate the clinical effects of applying nasal continuous positive airway pressure（NCPAP） combined with minimally invasive intragastric injection of pulmonary surfactant（PS） at different timings for neonatal respiratory distress syndrome（NRDS）.Methods Eighty-two children with NRDS admitted to a hospital in Henan from August 2017 to August 2020 were selected for this study.The children were divided into control and study groups using a random number table

with 41 cases in each group.The children in the control group were treated with NCPAP combined with minimally invasive intragastric PS injection 4 h after birth.The children in the study group were treated with NCPAP combined with minimally invasive intragastric PS injection within 2 to 4 h of birth.At 2 d of treatment

the clinical outcomes of the two groups were compared.The partial pressure of oxygen（Pa O2）

partial pressure of carbon dioxide（Pa CO2） and fraction of inspired oxygen（Fi O2） were compared between the two groups before treatment and at 24 h of treatment.The duration of oxygenation

hospital stay and complications at 2 d of treatment were compared between the two groups.Results The total effective rate of treatment for the children in the study group was 90.24%

which was higher than that of the control group（73.17%）

and the difference was statistically significant（P<0.05）.Before treatment

there was no statistically significant difference between the Pa O2

Pa CO2 and Fi O2 levels of the 2 groups（P>0.05）.At 24 h of treatment

Pa CO2 and Fi O2 levels were lowered in both groups than before treatment and lower in the study group than in the control group

with statistically significant differences（P<0.05）.At 24 h of treatment

the Pa O2 level was raised in both groups than those before treatment and higher in the study group than in the control group

with statistically significant differences（P <0.05）.The duration of oxygenation and hospital stay were shorter in the study group than in the control group

and the differences were statistically significant（P<0.05）.The complication rate of children in the study group was 7.32%

which was lower than that of 24.40% in the control group

and the difference was statistically significant（P<0.05）.Conclusion The application of NCPAP combined with minimally invasive intragastric PS injection for NRDS within 2 to 4 h of birth can improve Pa O2

Pa CO2

and Fi O2 levels

reduce the occurrence of complications

promote the recovery of children

and improve the clinical treatment effect

which makes it worthy of clinical promotion.