Objective To explore the application effect of hierarchical monitoring management combined with fine nursing in nursing of patients with severe craniocerebral injury.Methods A total of 120 patients with severe craniocerebral injury treated in a hospital in Henan province from June 2017 to August 2020 were selected as the subjects.The patients were randomly divided into observation group and control group

with 60 cases in each group.Patients in the control group received routine nursing.The patients in the observation group received hierarchical monitoring and management combined with fine nursing intervention on the basis of routine nursing.The hospitalization cost

first aid time（the firstaid time was the time from admission to the completion of emergency treatment） and hospital stays were compared between the two groups.The scores of fugl-meyer assessment（FMA）

national institutes of health stroke scale（NIHSS） and generic quality of life inventory（GQLI） were compared between the two groups before nursing and at discharge.The levels of intercellular adhesion molecule-1（ICAM-1）

interleukin-6（IL-6） and interleukin-8（IL-8） were compared between the two groups before nursing and at discharge.The incidence of pressure sore was compared between the two groups at discharge.Results The hospitalization cost of the observation group was lower than that of the control group

and the first-aid and length of stay（LOS） of the observation group were significantly shorter than those of the control group（P<0.05）.Before nursing

there was no significant difference in FMA

NIHSS and GQLI scores between the two groups（P>0.05）.At discharge

the scores of FMA and NIHSS in the two groups were lower than those before nursing

and those in the observation group were lower than those in the control group

the differences were statistically significant（P<0.05）.At discharge

the GQLI score of the two groups was higher than that before nursing

and that of the observation group was higher than that of the control group

and the difference was statistically significant（P<0.05）.Before nursing

there was no significant difference in the levels of ICAM-1

IL-6 and IL-8 between the two groups（P>0.05）.At discharge

the levels of ICAM-1

IL-6 and IL-8 in the two groups were lower than those before nursing

and those in the observation group were lower than those in the control group

and the difference was statistically significant（P<0.05）.The incidence of pressure sore in the observation group was 6.67%

which was lower than 21.67% in the control group

and the difference was statistically significant（χ~2=5.551

P<0.05）.Conclusion Hierarchical monitoring and management combined with fine nursing intervention can improve the inflammatory status of patients with severe craniocerebral injury

promote the recovery of motor and neurological function

improve the quality of life

reduce the incidence of pressure sores

shorten the time of first-aid and LOS

and reduce hospitalization costs

which is worthy of clinical application.