Objective To investigate the effect of the Segmented gradient follow-up in stage of rehabilita-tion to patients with medium-severe traumatic brain injury . Methods By convenience sampling , 44 patients with brain injury admitted to the department of neurosurgery of the 451 hospital of PLA from Jan-uary 2013 to August 2013 .They were selected and divided into observation group and control group with 22 patients in each group according to the table of random digits .The observation group was followed up with sub-gradient mode ,while the rehabilitation care guide ,routine discharge follow-up mission and gen-eral household follow up were used in control group .The prognosis for Karnofsky rating scale(KPS) , activities of daily living (ADL) and satisfaction with life scale(SWIS) were used to evaluate and compare of the data of two groups at 3 ,6 ,12 months after discharge .Results The results of the KPS and ADL of the observation group were significantly better than which in control group at 3 ,6 ,12 months after discharge (P< 0 .05) .There was no statistical significance between two groups while compared the SWIS at 3 months after discharge((P>0 .05) .There was statistical siginificance while compared the SWIS at 6 and 12 months after discharge(P<0 .05 or P<0 .01) .Conclusion The implement of the step gradient follow-up improve the functional status ,prognosis and daily living quality of the patients with medium-severe brain injury .%目的：了解中重型颅脑损伤康复阶段置管患者分段梯度随访的效果。方法2013年1-8月，便利抽样法选择解放军第451医院神经外科收治的颅脑损伤康复阶段患者44例，按随机数字表法将其分为观察组和对照组各22例，观察组进行分段梯度随访，对照组进行常规的康复指导、出院宣教及家庭随访。采用Karnlofsky预后评定表（KPS）、日常生活能力（activ-ity of daily living ，ADL）评定量表及生活满意度表（satisfaction withlife scale ，SWIS）在患者出院后3、6、12个月时对两组患者进行评价和比较。结果出院后3、6、12个月，观察组患者的KPS和ADL情况均优于对照组，差异均有统计学意义（均 P＜0．05）。出院后3个月，两组患者的SWIS差异无统计学意义（P＞0．05）；出院后6、12个月，观察组患者的SWIS均高于对照组，差异均有统计学意义（ P＜0．05或 P＜0．01）。结论分段梯度随访的实施改善了中重型颅脑损伤康复阶段置管患者的机能状态及预后，有利于提高患者的生活质量。
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