【摘要】 目的 探讨早产儿呼吸窘迫综合征(RDS)并发呼吸机相关肺炎(VAP)的临床特点和危险因素。方法 对新生儿重症监护病房26例并发VAP的RDS病人与同期应用呼吸机治疗超过48h的99例RDS患儿进行回顾性病例对照分析，比较两组患者的临床特点，采用非条件Logistic回归进行多因素分析，并计算OR值及OR的95%可信限(95%CI)。结果 RDS患儿并发VAP的发病率为20.80%，致病菌以革兰阴性菌为主(占76.92%)。VAP组病人与对照组平均住院时间比较差异有显著性(21.92±4.75d vs17.44±6.79d，P=0.002)。VAP组与对照组病死率比较差异有显著性(23.08%vs7.07%，P=0.044)。多因素非条件Logistic回归分析显示:气管内吸引(OR=3.299，95%CI=1.083～10.055)、动脉导管未闭(OR=3.987，95%CI=1.137～13.980)为RDS患儿并发VAP的危险因素。结论 VAP在RDS患儿中发生率高，气管内吸引、动脉导管未闭与VAP的发生有密切关系。

    关键词 呼吸机相关肺炎 呼吸窘迫综合征 早产儿 危险因素

    Case-control study on ventilator-associated pneumonia in premature

    respira tory distress syndrome

    Ruan Xiaohao，Gu Meihong，Yuan Tianming Children’s

    Hospital，Medical School of Zhejiang University，Hangzhou310003.

    【Abstract】 Objective To explore the clinical characteristics and risk factors of ventilator-associated pneuˉmonia(VAP)in premature respiratory distress syndrome(RDS).Methods A retrospective case-control study was conducted on125RDS patients who were cured by ventilator more than48hours.Non-conditional logistic regression analysis was performed to determine independent predictors for ventilator-associated pneumonia.The odds ratios(OR)and their95%confidence interva ......