Severe craniocerebral trauma is a common emergency in brain surgery, which is characterized by heavy condition, complex and changeable, many complications and high morbidity and mortality rate. Therefore, patient care should be careful, timely and accurate in observing the condition; care should be meticulous, thoughtful and comprehensive. And craniocerebral injury patient care is divided into: acute care and rehabilitation care. Acute care: a. Because of craniocerebral injury patients in the acute phase of high mortality, monitoring wards, the use of monitoring equipment to measure blood pressure, pulse, respiration, oxygen saturation, etc., while closely observe consciousness, pupils and limb activity, make written records. And to keep the environment quiet. Consciousness: Apply Glasgow coma scale and correctly distinguish between unconsciousness, hibernation state and impaired consciousness after surgery. Pupil: The normal pupil diameter is 2~5mm, bilateral equal size and equal garden, with sensitive light reflex. Otherwise, it may indicate the occurrence of brain herniation. Vital signs: blood pressure, pulse, respiration can reflect the function of the vital center and changes in intracranial pressure. In the case of craniocerebral injury, elevated blood pressure often indicates intracranial hypertension, mostly seen in cerebral edema and intracranial hemorrhage. If the blood pressure drops, it indicates poor circulatory function, especially when the central circulatory failure is more serious, we must pay close attention to it and adjust the medication in time to keep the blood pressure stable. If “two slow and one high” (slow respiration, slow pulse rate and elevated blood pressure) occur early, and the intracranial pressure rises, it indicates the possibility of brain herniation, so the condition should be reported to the doctor in time to cooperate with rescue treatment. Keep the airway unobstructed. Pay close attention to the observation, prevent the occurrence of airway obstruction and misaspiration, maintain normal ventilation, and ensure effective oxygen supply. Do blood gas analysis regularly, and dynamically observe the partial pressure of oxygen and carbon dioxide to guide the respiratory management. For patients with severe hypoxia and central respiratory dysfunction, ventilator-assisted breathing should be performed. For patients with persistent coma, weakened coughing ability, secondary respiratory infection or respiratory obstruction, tracheotomy should be performed, mask oxygen should be given, and the three hurdles of aseptic operation, endotracheal drug drip and timely and correct aspiration should be kept in order to avoid and reduce the occurrence of complications. Fourth, reduce intracranial pressure Craniocerebral injury patients due to bleeding, edema and other reasons will inevitably lead to the patient’s intracranial pressure increased, endangering life. Therefore, various means must be taken to reduce intracranial pressure. For postoperative patients with craniocerebral injury, combined with the patient’s consciousness, vital signs can predict whether it is postoperative hemorrhage or cerebral edema, general postcranial hemorrhage is likely to occur within 24 hours, cerebral edema generally peaks in the postoperative 48 to 72 hours, therefore, monitoring intracranial pressure within 3 days after surgery is very meaningful, such as intracranial pressure is elevated, by the general treatment capacity to reduce, can further take cranial CT scan, cerebral angiography If the intracranial pressure is elevated and the capacity is reduced by general treatment, further cranial CT scan and cerebral angiography can be taken to find the cause, so as to decide whether to treat dehydration or surgical decompression. V. Elevate the head appropriately, avoid forward flexion, hyperextension and lateral rotation, and avoid stimulating the patient and causing violent fluctuations in intracranial pressure by various nursing operations as gently and carefully as possible. Properly control the intake of water and sodium, accurately collect and record the daily urine volume, maintain the water and electrolyte balance, and strive to achieve the principles of rapid, adequate and punctual treatment of various dehydrating agents. Six, control central hyperthermia Craniocerebral injury patients are often involved in the thalamus thermoregulatory center, the incidence of central hyperthermia is very high, is bound to further aggravate the brain damage. The patient should be placed in an environment where it is easy to dissipate heat, room temperature is appropriate to maintain at about 22 ℃, in the head, neck, axilla, groin and other parts of the patient with high fever placed ice, or scrub the above parts with warm water to perform physical cooling, or the application of medical temperature control blanket. If necessary, hibernation therapy can be used to lower the metabolic rate, reduce oxygen consumption, protect cell membranes, and reduce the occurrence of cerebral edema. Rehabilitation care: When the patient’s condition is stable, the focus of nursing work enters the rehabilitation care stage. First, replenish energy, promote the body recovery center within a week after the injury, because the patient’s condition is unstable, digestive disorders, should not eat, or should not eat normally, mainly through the intravenous giving gastrointestinal nutrition, a week later, the patient’s condition more began to stabilize, can eat, then should follow the principle of regular, quantitative, from less to more, from thin to dry. In comatose patients, nasal feeding is feasible. Before each nasal feeding, gastric juice should be extracted to observe its color, volume and properties, and nasal feeding should be observed for abdominal distension, nausea and vomiting and stool. If there is abdominal distension, vomiting, bloody gastric juice or tarry stool, or if the gastric contents exceed 150 ML, fasting should be done immediately, and report to the doctor for corresponding treatment. Second, strengthen the basic care, prevention of complications craniocerebral injury patients often have limited limb movement with consciousness obstruction, loss of self-care ability or decline, the body’s immunity is weakened, very easy to complicate bedsores and all kinds of infections. Therefore, basic care must not be neglected. Indoor air should be kept clean, visitation should be reduced, and all kinds of treatment and nursing operations should be strictly aseptic. Gastric tubes and catheters should not be left in place for too long, and oral care should be provided once a day in the morning and once a day in the evening. A turning card system should be established, with regular turning and back patting. The principles of functional exercise for the paralyzed limbs are: combination of movement and stillness, muscle and bone, mind and body, and cooperation between doctors and patients; and effective methods, gradual progress and perseverance. We should pay attention to passive functional exercises in bed, and patiently instruct the family members to teach the patient to complete the movements of flexion and extension, adduction and abduction of the affected limb. After the removal of tracheal tube and gastric tube, get out of bed as soon as possible, with active exercise as the main activity and passive activity as the supplement. Comprehensive rehabilitation training Self-care training: Give nutritious food with high protein, high calories and high vitamins, and encourage patients to eat and brush their teeth by themselves if possible to cultivate self-confidence. Training bladder sphincter function: Give continuous tube clamping and regular urine release to exercise its contraction function and prepare for tube dialing. Prior to discharge, specific nursing concepts and nursing methods will be taught to patients and their families as an important part of the discharge rehabilitation instruction, so as to fully motivate patients and their families, enhance the desire for rehabilitation and self-confidence without delaying the rehabilitation treatment, and change from substitute care to self-care in a timely manner. Good nursing care is an important factor affecting the prognosis of patients with craniocerebral injury.