Objective To investigate the risk factors and preventive measures of ventilator - associated pneumonia in neonates. Methods A total of 160 neonates underwent mechanical ventilation were selected in the People′s Hospital of Jingjiang from March 2013 to March 2016,and they were divided into control group( did not complicate with ventilator - associated pneumonia,n = 114) and observation group( complicated with ventilator - associated pneumonia,n = 46) according to the incidence of ventilator - associated pneumonia. Clinical data was compared between the two groups,and risk factors of ventilator- associated pneumonia in neonates were analyzed. Results The fatality rate of observation group was statistically significantly higher than that of control group(P < 0. 05). No statistically significant differences of male proportion or cesarean delivery ratio was found between the two groups( P > 0. 05);premature birth rate,APACHE Ⅱ score,utilization rates of prophylactic antibiotics and antacid,utilization rate of nasal catheter,incidence of stomach contents reflux and primary lung disease of observation group were statistically significantly higher than those of control group,body weight and serum albumin level of observation group were statistically significantly lower than those of control group, duration of mechanical ventilation of observation group was statistically significantly longer than that of control group,while sputum suction times of observation group was statistically significantly more than that of control group(P < 0. 05). Multivariate logistic regression analysis showed that, premature delivery〔OR = 0. 627,95% CI(0. 327,0. 715)〕,body weight〔 OR = 0. 891,95% CI(0. 731,0. 905)〕, serum albumin level 〔 OR = 0. 578,95% CI ( 0. 521,0. 790 )〕,APACHE Ⅱ score 〔 OR = 0. 916,95% CI ( 0. 351, 0. 941)〕,use of prophylactic antibiotics〔OR = 0. 521,95% CI(0. 421,0. 783)〕,use of antacid〔 OR = 0. 683,95% CI (0. 529,0. 715)〕,duration of mechanical ventilation〔OR = 0. 716,95% CI(0. 489,0. 841)〕,use of nasal catheter〔OR= 0. 371,95% CI(0. 290,0. 573)〕,sputum suction times〔 OR = 0. 574,95% CI(0. 458,0. 710)〕,stomach contents reflux〔OR = 0. 682,95% CI(0. 579,0. 735)〕 and primary lung disease〔 OR = 0. 714,95% CI(0. 682,0. 857)〕 were risk factors of ventilator - associated pneumonia in neonates( P < 0. 05). Conclusion Premature delivery,body weight, serum albumin level,APACHEⅡ score,use of prophylactic antibiotics,use of antacid,duration of mechanical ventilation, use of nasal catheter,sputum suction times,stomach contents reflux and primary lung disease are risk factors of ventilator -associated pneumonia in neonates,medical workers should adopt targeted and effective preventive measures to reduce the incidence of ventilator - associated pneumonia in neonates.%目的：探讨新生儿呼吸机相关性肺炎的危险因素及其预防措施。方法选取2013年3月—2016年3月于靖江市人民医院行机械通气治疗的新生儿160例，按是否发生呼吸机相关性肺炎分为观察组46例（并发呼吸机相关性肺炎）与对照组114例（无呼吸机相关性肺炎）。比较两组患儿临床资料并分析新生儿呼吸机相关性肺炎的危险因素。结果观察组患儿病死率高于对照组（P <0.05）。两组患儿男性比例、剖宫产率比较，差异无统计学意义（P>0.05）；观察组患儿早产率、急性生理学与慢性健康状况评分系统Ⅱ（APACHEⅡ）评分、预防性抗生素使用率、抗酸剂使用率、鼻导管使用率、胃内容物反流发生率、肺部原发疾病发生率高于对照组，体质量、血清清蛋白水平低于对照组，机械通气时间长于对照组，吸痰次数多于对照组（P <0.05）。多因素 logistic 回归分析结果显示，早产〔OR=0.627，95% CI（0.327，0.715）〕、体质量〔 OR =0.891，95% CI（0.731，0.905）〕、血清清蛋白水平〔 OR=0.578，95% CI（0.521，0.790）〕、APACHEⅡ评分〔 OR =0.916，95% CI（0.351，0.941）〕、使用预防性抗生素〔OR =0.521，95% CI（0.421，0.783）〕、使用抗酸剂〔OR =0.683，95% CI（0.529，0.715）〕、机械通气时间〔OR=0.716，95% CI（0.489，0.841）〕、使用鼻导管〔OR =0.371，95% CI（0.290，0.573）〕、吸痰次数〔OR =0.574，95% CI（0.458，0.710）〕、胃内容物反流〔 OR =0.682，95% CI（0.579，0.735）〕、肺部原发疾病〔 OR =0.714，95% CI（0.682，0.857）〕是新生儿呼吸机相关性肺炎的危险因素（ P <0.05）。结论早产、体质量、血清清蛋白水平、APACHEⅡ评分、使用预防性抗生素及抗酸剂、机械通气时间、使用鼻导管、吸痰次数、胃内容物反流、肺部原发疾病是新生儿呼吸机相关性肺炎的危险因素，医护人员应采取有针对性的、有效的预防措施以减少新生儿呼吸机相关性肺炎的发生。
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