新生儿呼吸窘迫综合征(respiratory distress syndrome, RDS)是因肺表面活性物质(pulmonary surfactant, PS)缺乏导致出生后呼吸窘迫的危重疾病,围产期全程综合干预可显著改善预后。RDS管理的核心目标是提高婴儿存活率并最大限度减少肺损伤。基于最新循证医学证据,欧洲新生儿科及产科专家联合制定了《欧洲新生儿呼吸窘迫综合征管理共识指南2025版》。该指南对早产儿RDS的管理提供涵盖产前干预、产房稳定、PS应用、无创及有创呼吸支持,以及综合支持治疗的全流程临床建议,旨在通过精准干预降低肺损伤的发生率,提高存活率,改善远期神经发育结局。该文对照2022版指南,对新版指南进行解读,以期提高我国新生儿科医师对RDS的诊疗水平。
Neonatal respiratory distress syndrome (RDS) is a critical disease caused by pulmonary surfactant (PS) deficiency, leading to respiratory distress soon after birth. Comprehensive perinatal interventions can significantly improve outcomes. The core goal of RDS management is to maximize infant survival while minimizing lung injury. Based on the latest evidence, European neonatologists and obstetricians jointly developed the "European consensus guidelines on the management of respiratory distress syndrome: 2025". The guidelines provide evidence-based clinical recommendations for the management of RDS in preterm infants, covering the entire pathway from prenatal interventions, delivery room stabilization, surfactant administration, non-invasive and invasive respiratory support, to comprehensive supportive care. The aim is to reduce the incidence of lung injury through targeted interventions, increase survival rates, and improve long-term neurodevelopmental outcomes. This article interprets the 2025 guidelines in comparison with the 2022 version, aiming to improve the clinical competence of Chinese neonatologists in the diagnosis and treatment of RDS.