术后胃肠功能障碍的改善策略：从传统管理到最新研究进展

Improvement Strategies for Postoperative Gastrointestinal Dysfunction: From Traditional Management to the Latest Research Developments

摘要: 术后胃肠功能障碍(POGD)是腹部手术后常见的肠道运动和分泌功能恢复迟缓症状，主要表现为恶心、呕吐、腹胀和排气或排便的延迟。POGD不仅严重影响患者的康复和生活质量，还显著增加医疗资源的使用。胃肠功能障碍的发生受到手术技术、麻醉方法、疼痛控制及营养支持等多种因素的影响。随着POGD管理策略的发展，包括药物治疗、营养支持方案、微生物群调整以及加速康复外科(ERAS)措施的应用，已显著降低了POGD的发生率，并加速了患者的康复过程。本文综述了当前的POGD管理策略，探讨了治疗中的挑战，并为临床医生提供一个全面的治疗框架，以期望进一步提升手术后患者的治疗效果。

Abstract: Postoperative gastrointestinal dysfunction (POGD) is a common condition following abdominal surgery, characterized by delayed recovery of intestinal motility and secretory functions, leading to symptoms such as nausea, vomiting, abdominal distension, and delayed gas or bowel movements. POGD not only severely affects patients’ recovery and quality of life but also significantly increases the use of medical resources. The occurrence of gastrointestinal dysfunction is influenced by various factors, including surgical techniques, anesthesia methods, pain control, and nutritional support. With the development of POGD management strategies, including pharmacotherapy, nutritional support plans, microbiota modulation, and the application of Enhanced Recovery after Surgery (ERAS) protocols, there has been a notable decrease in the incidence of POGD and an acceleration in the recovery process of patients. This article reviews current POGD management strategies, discusses challenges in treatment, and provides a comprehensive treatment framework for clinicians, aiming to further improve postoperative outcomes for patients.