Objective:To compare the effects of non-invasive bi-level pressure triggering (BiPhasic tr) on oxygenation index (OI), partial pressure of oxygen and utilization rate of mechanical ventilation in premature infants with respiratory distress syndrome (RDS).Methods:The clinical data of 100 premature infants with RDS in Shantou Dafeng Hospital of Guangdong Province from March 2018 to May 2019 were retrospectively analyzed. Among them, 56 cases treated with nasal continuous positive airway pressure (nCPAP) were enrolled as control group, and 44 cases treated with BiPhasic tr were as observation group. The OI, arterial partial pressure of oxygen (PaO 2) and arterial partial pressure of carbon dioxide (PaCO 2) before and after respiratory support, duration of auxiliary ventilation, utilization rate of mechanical ventilation and incidence of complication were compared between 2 groups. Results:There were no statistical difference in PaO 2, PaCO 2 and OI before respiratory support between 2 groups ( P>0.05); the PaO 2, PaCO 2 and OI 1, 6, 12 and 24 h after respiratory support in 2 groups were significantly improved compared with those before respiratory support, and the improvement degree in observation group were significantly better than those in control group, and there were statistical differences ( P<0.05). The duration of auxiliary ventilation, utilization rate of mechanical ventilation, incidence of complication in observation group were significantly lower than those in control group: (52.41 ± 16.53) h vs. (57.42 ± 17.82) h, 11.36% (5/44) vs. 19.64% (11/56) and 15.91% (7/44) vs. 33.93% (19/56), and there were statistical differences ( P<0.05). Conclusions:BiPhasic tr can effectively improve the oxygenation state, reduce the use rate of mechanical ventilation and carbon dioxide retention, reduce the incidence of complications such as intraventricular hemorrhage and so on in the treatment of RDS premature infants.