Abstract： Objective To explore the efficacy of combination therapy of poractant alfa injection and noninvasive ventilation on neonatal respiratory distress syndrome(NRDS).Methods A total of 102 children with NRDS were selected as the study subjects from February 2021 to April 2023.Among these children,57 cases received noninvasive ventilation treatment and were set as group A.Another 45 cases were treated with poractant alfa injection combined with noninvasive ventilation and were assigned as group B.The two groups of patients were matched according to 1:1 nearest approach matching method(calliper=0.1),and then 78 patients(39 cases with noninvasive ventilation treatment and 39 cases with combined treatment)were matched successfully.Thus,39 pairs of patients with comparable baseline data were finally obtained.The clinical efficacy after 5 days of treatment and related clinical indicators were compared.The blood gas indicators[partial pressure of carbon dioxide(PaCO2),partial pressure of oxygen(PaO2),arterial oxygen saturation(SaO2)],inflammatory response[serum C-reactive protein(CRP),procalcitonin(PCT)],myocardial injury[serum creatine kinase(CK),serum creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH)]were recorded before treatment and after 5 days of treatment.Results After 5 days of the treatment,group B had obviously better clinical efficacy(P=0.033).The related clinical indicators in group B were lower compared to group A(P=0.040,0.029).The PaO2 and SaO2 in both groups were significantly increased,and the group B had higher PaO2 and SaO2 than those in group A(P＜0.05).The PaCO2,CRP,PCT,CK,CK-MB and LDH were significantly decreased in the two groups,and the above indicators were lower in group B(all P＜0.01).Conclusion Poractant alfa combined with noninvasive ventilation has an exact efficacy in the treatment of children with NRDS.It can significantly improve the blood gas indicators,reduce the inflammatory factors,and relieve the myocardial injury.