随着围产医学和极早产儿救治水平的提高，近年来新生儿呼吸窘迫综合征（NRDS）等早产儿严重呼吸系统并发症的发病率不断升高。尽管我国NRDS的诊治水平已经取得了长足的进步，但是重度颅内出血、支气管肺发育不良等并发症的发生率仍显著高于欧美发达国家。当前，NRDS的诊治仍面临一些挑战，如NRDS与新生儿急性呼吸窘迫综合征（NARDS）早期鉴别诊断困难，可能导致部分患儿未能获得有效治疗。同时，NRDS治疗中的部分科学问题存在争议，如肺表面活性物质的使用时机、有创通气模式的选择、撤机后过渡通气策略选择等，临床均未达成共识，或者虽有共识却基于并不完备的临床证据。依托国家战略支持和中国新生儿协作网等多中心协作平台，我国学者近期在BMJ等权威期刊接连发表一系列关于NRDS的高质量临床研究成果，直面当前诊疗中的争议与挑战，为用中国数据改善患儿预后提供了坚实证据。本文将梳理NRDS的诊疗现状、最新关键发现及未来研究方向，以提升临床医师的认知水平。

With advances in perinatal medicine and improved care for extremely preterm infants, the incidence of severe respiratory complications—such as neonatal respiratory distress syndrome (NRDS)—has risen in recent years. Although the diagnosis and management of NRDS in China have made substantial progress, rates of severe complications, including severe intracranial hemorrhage and bronchopulmonary dysplasia (BPD), remain markedly higher than those observed in high-income countries in Europe and North America. Current clinical practice faces several critical challenges, including difficulties in the early differentiation of NRDS from neonatal acute respiratory distress syndrome (NARDS), which may delay timely and appropriate interventions. Furthermore, key therapeutic decisions lack robust evidence or consensus, such as the optimal timing of pulmonary surfactant administration, selection of invasive ventilation strategies, and post-extubation respiratory support approaches—some guidelines exist but are often based on limited or low-quality data. Leveraging national strategic initiatives and multicenter collaborative platforms like the China Neonatal Network (CHNN), Chinese researchers have recently published a series of high-impact studies on NRDS in leading journals including The BMJ, directly addressing these unresolved clinical questions and generating high-quality, context-specific evidence to improve outcomes. This article reviews the current landscape of NRDS management, highlights pivotal recent findings, and outlines future research priorities, in order to enhance the cognitive level of chinical physicians.