加速康复外科在结直肠手术中的范式演进与未来展望

The Paradigm Evolution and Future Perspectives of Enhanced Recovery after Surgery (ERAS) in Colorectal Surgery

摘要: 加速康复外科(ERAS)基于循证依据的多模式策略改善患者围手术期管理在结直肠外科领域取得显著成效。回顾ERAS在结直肠手术中的发展历程：早期“快速通道”思想提出之后逐步构建和实施多学科合作，进而发展成为融合风险分层与个体特征的“精准ERAS”阶段。文中重点介绍了术前预康复、微创手术联合目标导向液体治疗(GDFT)、术后多模式镇痛等循证医学改进，并针对临床实践推广过程中常见问题进行了探讨；未来加速康复外科(ERAS)将深度融合人工智能技术、移动医疗以及可穿戴设备等智能化工具，推动围手术期管理模式不断向实时动态监测、精准个性干预和全流程闭环管理不断发展，最终实现以患者安全为导向、治疗效率更高，康复过程人性化的优质结局。

Abstract: The evidence-based multimodal strategy of Enhanced Recovery after Surgery (ERAS) has achieved remarkable results in improving perioperative management of patients in the field of colorectal surgery. Looking back on the development of ERAS in colorectal surgery: After the early “fast track” concept was proposed, multidisciplinary cooperation was gradually constructed and implemented, and then it developed into the “precise ERAS” stage that integrates risk stratification and individual characteristics. This article mainly introduces the evidence-based medical improvements such as preoperative pre-rehabilitation, minimally invasive surgery combined with goal-directed fluid therapy (GDFT), and postoperative multimodal analgesia, and discusses the common problems in the process of clinical practice promotion. In the future, Enhanced Recovery after Surgery (ERAS) will deeply integrate intelligent tools such as artificial intelligence technology, mobile healthcare, and wearable devices, promoting the continuous development of perioperative management models towards real-time dynamic monitoring, precise personalized intervention, and full-process closed-loop management. Ultimately, it aims to achieve a high-quality outcome oriented towards patient safety, with higher treatment efficiency and a humanized rehabilitation process.