Abstract: Objective To study the clinical features and key points of prevention and treatment of neonatal respiratory distress syndrome (NRDS) complicated with pneumothorax.Methods A retrospective analysis was conducted on clinical data of 27 neonates with NRDS complicated with pneumothorax, who were admitted to the neonatal intensive care unit from October 2010 to October 2015.Results All 27 cases were preterm infants, of whom 24 cases were delivered by cesarean section, 13 cases were complicated with asphyxia, 11 cases were complicated with meconium aspiration syndrome, 9 cases were treated with positive pressure ventilation, in 3 of the cases the pneumothorax occurred during mechanical ventilation. Pneumothorax happened to 25 cases within 72 hours after birth, and the number of the patients who got pneumothorax within 24-48 hours after birth was 12. Most cases showed that respiratory distress was suddenly worsened or recurred again; 19 cases got increased heart rate. Only 3 cases developed signs of pneumothorax. For 24 cases conservative management was applied to have gas absorbed gradually, 3 cases underwent thoracic close drainage; 1 case gave up treatment, other cases had good prognosis. Conclusion NRDS is the leading cause of pneumothorax in preterm infants. Well understanding pathogenesis of NRDS complicated with pneumothorax, minimizing or eliminating potential risk factors are keys of effective prevention of pneumothorax. In order to diagnose and treat pneumothorax as early as possible and appropriately, it is necessary to improve awareness of this disease so that disease exacerbation could be controlled and preterm infants management could be improved.

Key words: neonatal respiratory distress syndrome, pneumothorax, preterm infant