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目的研究通气相关肺炎（ＶＡＰ）的致病危险因素。方法采用巢式病例对照研究的方法，对５８例确诊为通气相关肺炎（ＶＡＰ）的病例，按同科室、同性别、年龄相同或相近（±５岁），入院时间相同或相近（＜１周），病情相似，１∶１配以５８例对照探讨ＶＡＰ的危险因素。结果对２０多种可能的危险因素进行单因素分析。有１６种呈显著性差异。对这１６种主变量进一步进行多因素条件性Ｌｏｇｉｓｔｉｃ回归分析表明：基础病情重（ＯＲ＝９．４０）、留置胃管（ＯＲ＝８．８６）、患者意识状态差（ＯＲ＝８．３９）、气管切开（或插管）时间长（＞２周）（ＯＲ＝６．８９）、有颅脑外伤（ＯＲ＝６．６０）、频繁更换呼吸机接头插管（ＯＲ＝６．４４）、应激性溃疡预防用药（ＯＲ＝５．５２）、住院时间长（＞１月）（ＯＲ＝４．３１）为ＶＡＰ发生的独立危险因素。结论ＶＡＰ的发生是多因素综合作用的结果，且证明存在胃→咽→下呼吸道的逆行感染途径
Objective To study the risk factors of ventilator-associated pneumonia (VAP). Methods The nested case-control study was performed on 58 patients with VAP confirmed by the same department or same sex, with the same age or similar age (± 5 years) and the same or similar admission time (<1 week ), A similar condition, 1: 1 with 58 controls to explore the risk factors for VAP. Results One-way analysis of more than 20 possible risk factors. There are 16 kinds of significant differences. The multivariate conditional logistic regression analysis of these 16 main variables showed that the basic condition (OR = 9.40), indwelling gastric tube (OR = 8.86), poor patient consciousness (OR = 8.39) , Tracheotomy (or intubation) for a long time (> 2 weeks) (OR = 6.89), traumatic brain injury (OR = 6.60) , Stress ulcer prophylaxis (OR = 5.52), long hospital stay (> 1 month) (OR = 4.31) were independent risk factors for VAP. Conclusions The occurrence of VAP is the result of multifactorial combination and it is proved that retrograde infection of stomach → pharynx → lower respiratory tract exists