机械通气（MV）是外科患者手术全麻期间及重症患者常用的呼吸支持方法。近年来人们逐渐认识到MV是一把“双刃剑”，其本身也可作为一种损伤因素诱发或加重肺损伤，即呼吸机相关性肺损伤（VILI）。目前有关VILI发生机制的研究已从传统的气压伤、容积伤和肺不张转变为生物伤。尤其应当注意的是，MV不仅可引起肺自身损伤，还可诱发肺外远隔器官损伤。本文就目前关于VILI生物伤分子机制的研究进行综述，更新对VILI分子机制的认识，为防治VILI及远隔器官损伤提供理论依据。“,”Mechanical ventilation (MV) is a common way of respiratory support during general anesthesia and in critically ill patients. Recently people gradually realize that MV is a double-edged sword, which itself can also induce or aggravate lung injury as a damage factor, that is, ventilator induced lung injury (VILI). Current researches on the mechanisms of VILI have changed from traditional barotrauma/volutrauma/atelectasis to biotrauma. In particular, it should be noted that MV can not only cause damage to the lung, but also to the distant organs. This article reviews current researches on the molecular mechanisms of VILI, updates our understanding of them, and provides a theoretical basis for the prevention and treatment of VILI and distant organ damage.