第六十五章【气管切开术】（上）
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李香芝因为窒息已经陷入昏迷，所以无需进行麻醉。更多小说ltxs520.com
情况非常紧急，时间已经不允许胡小天从容地进行气管切开术，他当机立断对病人先实行环甲膜切开手术，首先缓解呼吸困难，然后再做常规气管切开术。
环甲膜是位于甲状软骨下部、环状软骨上部的一块气管壁。此处气管壁因为处于两块软骨之间，所以缝隙比较大，而且经过这里的血管神经较少，切开时不会造成大的出血和额外损伤。
胡小天迅速戴上自制的口罩，取出手术刀准确定位之后，刀锋切入李香芝颈部的皮肤。周围传来一阵阵的惊呼，胆小的女眷吓得已经转过头去，因为急于救人，胡小天刚刚忘记了清场这件事。他虽然是在救人，可这动作分明是在拿刀抹脖子，在多数人看来胡小天这根本是在谋杀啊！更有甚者已经当场吓晕了过去。
万伯平毕竟经历过了胡小天敲开他儿子脑壳的震撼，胡小天在他眼前切开他儿媳的脖子多少有了些心理承受能力，至少他知道胡小天是在救人，而不是谋杀。
胡小天在病人环甲膜暴露之后，用刀横向切开环甲膜，从手术箱中取出弯头血管钳，利用血管钳扩大切口，将一段事先准备好，消毒后的芦苇杆临时插入其中。胡小天的动作快捷干净利落，随着芦苇杆的插入，李香芝的窒息症状顿时得到了缓解。
她苏醒过来，睁大双眼。目光显得异常恐惧。
胡小天安慰她道：“没事，不用惊慌。你千万不要乱动，接下来我还要帮你取出喉头的异物。”李香芝在胡小天的安慰下渐渐镇定下来。
常规气管切开术对胡小天这位医学博士来说根本就是小得不能再小的手术，可是在这个时代却无疑是惊世骇俗的举动。
胡小天桀骜不驯的性情决定他很少在意周围人的眼光，只是在来到这里之后，他开始渐渐学会了审时度势适应周围的环境。可当他一心投入到救治病患的时候，就会忽略其他。
手术采用直切口，自甲状软骨的下缘至胸骨尚窝处，沿着颈前正中线切开皮肤和皮下组织。然后用血管钳沿着中线分离胸骨舌骨肌和胸骨甲状肌。暴露出甲状腺的峡部，李香芝的甲状腺峡部在生理结构上有些过宽，必须在下缘进行部分分离，然后将峡部组织向上牵拉，这样才将气管暴露出来，手术箱内备有拉钩，这拉钩的助手责无旁贷地落在了周文举的身上。周文举虽然和胡小天刚刚经历了一场激烈的争吵，但是他在抢救的全过程中表现得非常配合。胡小天叮嘱他两个拉钩的用力一定要均匀适度，好让自己的手术视野始终保持在中线。
手术的过程中，胡小天几次用手指探察环状软骨和气管，确定保持在正中位置，别看胡小天平日吊儿郎当玩世不恭。可是一旦进入手术状态就会全神贯注一丝不苟，确定气管的位置之后，他在第三气管环处下刀，用刀尖自下而上挑开两个气管环，用刀极其谨慎。以免刺破气管后壁和食管前壁。
因为有了上次救治万廷盛的经验，今天万府家丁将灯光打得格外到位。利用数面铜镜，让光线聚集在手术部位。胡小天很顺利地就发现了那块阻塞在气管内的牛肉，他用血管钳将牛肉夹住，那牛肉足有拇指盖大小，李香芝吃饭的时候因为心不在焉，竟然误吞到了气管里面，从而造成了阻塞，如果抢救不及只怕此时已经死了。
解决了气道梗阻的根本问题，接下来的缝合处理就相当简单了，为了以防万一，仍然将气管插管保留固定，倘若在过去，胡小天还要担心术后并发症等等诸般问题，可是他发现在这个世界上不知是人本身体质的问题还是致病菌比现代社会少得多的缘故，在他做过的几例手术中，没有发生过一例感染事件，应该说前者的可能性更大，在这里人体的自我修复能力都非常强。
胡小天向负责照顾李香芝的丫鬟婆子仔细交代了一番，告诉她们一些护理的基本常识，毕竟这帮人都有了护理万家老二的经验，上手并不困难。等忙完这一切，夜幕已经降临了。
周文举在胡小天传授护理常识给那些丫鬟婆子的时候始终旁听，他越听越是惭愧，越听越是心惊，亲眼目睹胡小天将李香芝从生死边缘挽救了回来之后，他打心底叹服，换成是他，李香芝肯定死了。其实周文举绝不是欺世盗名之辈，西川第一神医的名头也不是吹出来的，经他救治的病人不计其数，但是他的外科学知识可怜得很。
耳听为虚眼见为实，只有亲眼看到胡小天手术全程的人才知道何谓人外有人天外有天。
胡小天前去洗手的时候，周文举也过来洗手，两人目光相遇，彼此间已经没有了刚才的敌意，周文举抿了抿嘴唇，鼓足勇气道：“胡大人，刚才周某言行无状，如有得罪之处还望多多海涵！”
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