国际研究证实，早期足量抗凝可改善急性肠系膜缺血（AMI）患者生存率，且不增加出血风险。人工智能（AI）技术实现了床旁胃动力自动化评估，为个体化营养实施提供了新工具。大规模临床研究对重症患者常规应用高蛋白营养及益生菌/益生元提出挑战，强调干预措施的 “环境依赖性”。对 “肠-肺轴”机制及肠道菌群-耐药基因谱与预后关系的揭示，为感染防控开辟了新视角。应激性溃疡预防（SUP）研究则通过疗效异质性分析，指明了精准预防的方向。此外，伴血小板减少的胃肠出血重症患者输血策略方面也提出了优化方案。上述进展虽部分结论尚需验证，但共同为未来基于深度病理生理认知与前沿技术的个体化治疗奠定了坚实基础。本文对2025年重症胃肠领域的多项重要研究进行归纳与评述。

International evidence has demonstrated that early adequate anticoagulation improves survival in patients with acute mesenteric ischemia without increasing the risk of bleeding complications. Artificial intelligence-assisted automated bedside assessment of gastric motility assessment has emerged as a novel approach for individualized nutritional support in critically ill patients. Recent large-scale clinical trials have questioned the routine use of high-protein nutrition and probiotic/prebiotic supplementation in critical illness, highlighting the context-dependent efficacy of these interventions. Moreover, advances in understanding the gut-lung axis and the association between gut microbiota resistome profiles and patient prognosis have provided novel perspectives for infection prevention and management. Studies investigating stress ulcer prophylaxis, particularly through analyses of treatment-effect heterogeneity, have further advanced the concept of precision prevention. In addition, optimized transfusion strategies for thrombocytopenia-associated gastrointestinal bleeding in critically ill patients have been proposed. Although several of these findings still require further validation, collectively they provide a solid foundation for the development of individualized therapeutic strategies based on deeper pathophysiological understanding and emerging technologies. This review summarizes and critically appraises major advances in critical care gastroenterology reported in 2025.