目的 探讨PDCA护理模式在重型颅脑损伤患者颅内感染、肺部感染、泌尿系感染防治中的作用。方法 按时间段将重型颅脑损伤患者226例分为对照组(n=98)和观察组(n=128)。对照组按照常规护理，观察组在常规基础上应用PDCA(计划、执行、检查、处理) 循环管理模式，比较两组颅内感染、肺部感染、泌尿系感染的发生情况，并对感染的因素进行分析。结果 观察组感染发生率(48.3%)明显低于对照组(69.4%)，差异有统计学意义(P＜0.01)。观察组肺部感染(23.4%)、泌尿系感染发生率(18.8%)均低于对照组(46.9%和34.7%，均P＜0.01);两组颅内感染发生率比较差异无统计学意义。两组在术区外引流管、糖尿病、开放性颅脑损伤三个影响因素方面院内感染率比较，差异有统计学意义;在脑脊液漏气管切开、留置尿管、营养四个方面差异更明显。结论 运用PDCA 循环的护理模式对重型颅脑损伤患者进行护理可以降低院内感染率。

Objective To study the use of effective nursing mode of PDCA in prevention and treatment intracranial infection, pulmonary infection, and urinary tract infection in patients with severe head injury. Methods According to the time period, 226 patients with severe head injury were divided into control group of 98 cases and study group of 128 cases. The control group received the conventional nursing, the study group,based on the conventional nursing,employed of PDCA (plan, implementation,inspection, processing cycle management model). in the two groups Intracranial infection, pulmonary infection, urinary tract infection were compare, and the factors of infection was analyzed. Results The incidence rate of infection in the study group (48.3%) was significantly lower than that in the control group (69.4%), and the difference was statistically significant (P<0.01). The incidences of pulmonary infection (23.4%) and urinary tract infection (18.8%) in the study group were lower than those in the control group (46.9% and 34.7%, P<0.01), while there was no significant difference in the incidence of intracranial infection between the two groups.The difference in the operation area drainage tube, diabetes, three factors affecting open craniocerebral injury, nosocomial infection rate, between the two groups was statistically significant, and in four aspects of the cerebrospinal fluid leakage tube incision, indwelling catheter, and nutrition, the difference is more obvious. Conclusions Using PDCA circulation mode of nursing care can reduce infection rates in patients with severe head injury, improve the quality of nursing.