坏死性筋膜炎（NF）是结直肠肛门外科少见且致命的急危重症，具有起病隐匿、进展迅速、组织破坏严重及病死率高等特点，感染可沿筋膜间隙迅速播散，累及肛周、会阴、盆底乃至腹膜后等多个部位。传统诊疗模式多聚焦于急性期感染控制与手术清创，而对治疗后期的功能保护、分期重建及长期康复关注不足。全程管理理念强调从“防、筛、诊、治、康”多个维度构建全病程诊疗体系，通过多学科协作和个体化决策，将早期识别与鉴别诊断、影像学分层评估、急性期彻底清创与靶向抗感染、分期创面管理、功能重建及长期康复随访有机整合，以减少诊疗衔接断裂并优化整体预后。本文探讨NF全程管理理念在结直肠肛门外科中的临床应用，以及其在提高救治成功率和改善患者远期生活质量中的意义。

Necrotizing fasciitis (NF) is a rare, life-threatening acute critical illness in colorectal and anal surgery, characterized by insidious onset, rapid progression, extensive tissue destruction and high mortality. The infection can spread rapidly along fascial planes, involving the perianal region, perineum, pelvic floor, and even the retroperitoneal space. Traditional management has mainly focused on infection control and surgical debridement during the acute phase, while insufficient attention has been paid to functional preservation, staged reconstruction, and long-term rehabilitation in the later course of treatment. The concept of whole-course management emphasizes the establishment of a comprehensive care system spanning prevention, screening, diagnosis, treatment and rehabilitation. Through multidisciplinary collaboration and individualized decision-making, it integrates early recognition and differential diagnosis, imaging-based stratified assessment, thorough debridement and targeted antimicrobial therapy in the acute phase, staged wound management, functional reconstruction and long-term rehabilitation follow-up, thereby reducing gaps in care and optimizing overall prognosis. This review discusses the clinical application of the whole-course management concept for NF in colorectal and anal surgery, and its significance in improving treatment success rate and patients’ long-term quality of life.