Abstract: Objective To observe the efficacy of pernasal intermittent positive pressure ventilation(NIPPV)combined with high-dose bovine lung surfactant in the treatment of severe neonatal respiratory distress syndrome(NRDS)and explore its effects on the expressions of serum interleukin-6(IL-6), bone morphogenetic protein-7(BMP-7), and transforming growth factor-β₁(TGF-β₁). Methods A total of 78 children with severe NRDS were selected as research objects and were divided into study group(n=39)and control group(n=39)according to the random number table method. Patients in both groups were all given NIPPV on the basis of conventional treatment, and the study group was given high-dose bovine lung surfactant. The efficacy, oxygen therapy time, mechanical ventilation time, length of hospital stay, incidence of disease-related complications, and levels of serum IL-6, BMP-7, TGF-β₁ before and after treatment were compared. Besides, partial pressure of carbon dioxide in arterial blood ［p_a(O₂)］, partial pressure of carbon dioxide in arterial blood ［p_a(CO₂)］, and pH value of the two groups were compared. The neonates were followed up to eighteen months of adjusted age after treatment, lung function indicators［tidal volume(VT), ratio of volume to peak expiratory - flow(VPEF)to total expiratory volume(VE)(VPEF/VE), ratio of time to peak tidal expiratory flow (TPTEF)to total expiratory time(TE)(TPTEF/TE), and respiratory rate(RR)］ were compared between the two groups. Results After treatment, the total effective rate in the study group was significantly higher than that in the control group, the incidence of disease-related complications was significantly lower than that in the control group(P<0.05); the oxygen treatment time, mechanical ventilation time, and hospital stay of the study group were significantly shorter than those of the control group(P<0.05); after treatment, the levels of p_a(O₂)and pH value in the two groups were significantly higher than before treatment(P<0.05), and p_a(CO₂)as well as serum IL-6, BMP-7, TGF-β₁ levels were significantly lower than those before treatment, and the change degrees of above indicators in the study group were significantly more than the control group(P<0.05). Follow-up to adjusted eighteen months of age showed that the levels of VT, VPEF/VE, TPTEF/TE in the study group were significantly higher than those in the control group, and the RR level was significantly lower than that in the control group(P<0.05). Conclusion NIPPV combined with high-dose bovine lung surfactant can improve blood gas in children with severe NRDS, reduce the expressions of serum IL-6, BMP-7 and TGF-β₁, and relieve the inflammatory reactions. Besides, it can reduce the occurrence of disease complications, improve the lung function and promote the recovery of children.