腹部手术术后胃肠功能恢复的影响因素研究 进展

Research Progress on Influencing Factors of Gastrointestinal Function Recovery Following Abdominal Surgery

摘要: 腹部手术后胃肠功能的恢复状况与患者术后康复进程及预后质量密切相关。但影响术后胃肠功能恢复的因素涉及多个层面，有手术创伤程度、麻醉方案选择、术后营养支持策略以及患者术前基础状态等。近年来，随着加速康复外科理念的深入推广以及微创外科技术的广泛应用，术后胃肠功能恢复这方面的研究取得了显著进展。有研究表明，上述因素主要通过调控肠道神经内分泌功能、介导炎症反应及影响肠道菌群稳态等途径发挥作用。然而，临床实践中仍可观察到明显的个体差异现象：接受相同术式的患者，部分可于术后2至3日内恢复肛门排气排便功能，而另一部分则可能延迟至1周甚至更长时间，这一差异背后的具体机制尚未完全阐明。本文旨在对近年来腹部手术后胃肠功能恢复影响因素的相关研究进展进行系统梳理与综述，以期为临床决策提供理论依据与参考。

Abstract: The recovery of gastrointestinal function following abdominal surgery is closely associated with postoperative rehabilitation progress and prognostic outcomes. Factors influencing postoperative gastrointestinal recovery encompass multiple dimensions, including the extent of surgical trauma, anesthetic regimen selection, postoperative nutritional support strategies, and preoperative baseline patient status. In recent years, with the widespread implementation of enhanced recovery after surgery protocols and the extensive adoption of minimally invasive surgical techniques, substantial research advances have been achieved in this field. Current evidence indicates that these factors exert their effects primarily through modulation of intestinal neuroendocrine function, mediation of inflammatory responses, and alteration of gut microbiota homeostasis. Nevertheless, considerable inter-individual variability remains evident in clinical practice: among patients undergoing identical surgical procedures, some achieve restoration of flatus passage and defecation within 2 to 3 postoperative days, whereas others may experience delays extending to one week or longer. The precise mechanisms underlying this heterogeneity have yet to be fully elucidated. This review aims to systematically synthesize recent research advances regarding factors affecting gastrointestinal function recovery following abdominal surgery, with the objective of providing theoretical foundations and reference for clinical decision-making.