引用文本：陈俊强, 毛远天, 柳思雨. 肠道菌群与加速康复外科：机制探索与临床转化新方向[J/CD]. 消化肿瘤杂志（电子版）, 2026, 18(2): 209-216.

作者：陈俊强, 毛远天, 柳思雨

单位：广西医科大学第一附属医院胃肠腺体外科，广西消化道肿瘤加速康复外科基础研究重点实验室，广西加速康复外科临床医学研究中心，广西 南宁 530021

Authors：Chen Junqiang, Mao Yuantian, Liu Siyu

Unit：Department of Gastrointestinal Surgery, the First Affiliated Hospital of Guangxi Medical University, Guangxi Key Laboratory of Enhanced Recovery After Surgery for Gastrointestinal Cancer, Guangxi Clinical Research Center for Enhanced Recovery After Surgery, Nanning 530021, Guangxi Zhuang Autonomous Region, China

摘要：

肠道菌群被誉为“被遗忘的器官”与“人类第二基因组”，是一个与宿主及外界环境紧密互作的复杂生态系统。近年发现肠道菌群与加速康复外科（enhanced recovery after surgery, ERAS）的临床效果密切相关。围手术期干预肠道菌群（如使用益生菌、合生元等）可改善手术预后，其核心机制涉及免疫调节、炎症调控、感染防控、营养代谢及肠道功能恢复五大方面。本文系统阐述了手术对肠道菌群的直接影响，深入剖析了上述五大作用机制，并结合最新研究，探讨了将肠道菌群调控整合于ERAS流程的新方向，包括个体化益生菌治疗、优化围手术期肠道准备、靶向调控术后炎症与肠道屏障等，旨在为未来机制深度探索与临床精准转化提供新思路。

关键词：肠道菌群；加速康复外科；机制；临床转化

Abstract：

The gut microbiota, hailed as the "forgotten organ" and the "second human genome", is a complex ecosystem that interacts closely with the host and the external environment. Recent findings suggest that the gut microbiota is closely associated with the clinical efficacy of enhanced recovery after surgery (ERAS). Perioperative interventions targeting the gut microbiota (e.g., administration of probiotics and synbiotics) can improve surgical outcomes, and the core mechanisms involve five major aspects: immune regulation, inflammatory control, infection prevention and management, nutritional metabolism, and intestinal function recovery. This paper systematically elaborates on the direct impacts of surgery on the gut microbiota, analyzes the aforementioned five mechanisms in depth, and further explores new directions for integrating gut microbiota modulation into the ERAS protocol based on the latest research findings. These directions include personalized probiotic therapy, optimization of perioperative bowel preparation, and targeted regulation of postoperative inflammation and intestinal barrier function. The aim is to provide novel insights for in-depth exploration of underlying mechanisms and precise clinical translation in the future.

Key words：Gut microbiota; Enhanced recovery after surgery; Mechanism; Clinical translation

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