患者,女,44岁,因“车祸伤并昏迷40 min”入院。门诊CT平扫检查提示:颅内多发积气,无明显血肿;肝脏、胆囊、胰腺、脾脏及双肾未见明显损伤;L_2左侧横突骨折。查体:血压90/60 mmHg,昏迷,躁动,双侧瞳孔不等大,颈软,气管居中,胸廓无畸形,双肺呼吸音清晰,对称,腹部平软,上腹壁见大片皮肤挫伤,四肢肌张力正常。急诊行气管切开和伤处清创,术中血压下降为65/40 mmHg,腹部 The patient, female, 44 years old, was hospitalized because of a “car accident and a coma 40 minutes.” Clinic CT scan examination prompt: intracranial multiple gas, no obvious hematoma; liver, gallbladder, pancreas, spleen and kidney no obvious damage; L 2 left transverse process fracture. Physical examination: blood pressure 90/60 mmHg, coma, agitation, bilateral pupil ranging from large, soft neck, tracheal center, thoracic deformity, lung breath sounds clear, symmetrical, flat abdomen, large abdominal skin contusion, limbs Muscle tension normal. Emergency tracheotomy and wound debridement, intraoperative blood pressure dropped to 65/40 mmHg, abdomen