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关节镜下髓心减压术联合富血小板血浆治疗距骨骨髓水肿 被引量:1
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作者 许岩 贺磊 +4 位作者 段德宇 刘国辉 王俊文 肖飞 欧阳柳 《中华创伤杂志》 CAS CSCD 北大核心 2022年第4期327-331,共5页
目的探讨关节镜下髓心减压术联合富血小板血浆(PRP)治疗距骨骨髓水肿的疗效。方法采用回顾性病例系列研究分析2018年1月至2020年7月华中科技大学同济医学院附属协和医院收治的17例距骨骨髓水肿患者的临床资料, 其中男11例, 女6例;年龄15... 目的探讨关节镜下髓心减压术联合富血小板血浆(PRP)治疗距骨骨髓水肿的疗效。方法采用回顾性病例系列研究分析2018年1月至2020年7月华中科技大学同济医学院附属协和医院收治的17例距骨骨髓水肿患者的临床资料, 其中男11例, 女6例;年龄15~56岁[(45.7±4.3)岁]。均采用关节镜下髓心减压术联合PRP治疗。记录手术时间, 观察伤口愈合情况。比较术前、术后6, 12个月使用MRI测量的距骨骨髓水肿最大面积, 踝关节活动度(ROM)。术前、术后6, 12个月采用视觉模拟评分(VAS)及美国足踝外科协会(AOFAS)踝-后足评分评估疼痛情况及踝关节功能。观察并发症情况。结果患者均获随访12~41个月[(16.7±2.1)个月]。手术时间为45.2~68.5 min[(53.4±12.4)min]。伤口均Ⅰ期愈合。骨髓水肿最大面积由术前(28.2±6.9)mm2减小至术后6, 12个月的(16.3±5.7)mm2、(7.1±1.7)mm2(P均<0.01);踝关节ROM由术前(52.2±8.9)°增加至术后6, 12个月的(72.3±3.1)°、(83.1±2.8)°(P均<0.01);VAS由术前(8.2±0.6)分减少至术后6, 12个月的(6.5±0.4)分、(3.1±0.8)分(P均<0.01);AOFAS踝-后足评分由术前(32.4±4.8)分增加至术后6, 12个月的(54.4±6.5)分、(88.7±4.3)分(P均<0.01)。与术后6个月比较, 术后12个月骨髓水肿最大面积、踝关节ROM、VAS及AOFAS踝-后足评分差异有统计学意义(P均<0.01)。1例患者术后出现局部皮肤麻木, 行营养神经治疗后好转。结论关节镜下髓心减压术联合PRP治疗距骨骨髓水肿能有效减少骨髓水肿范围、提升踝关节活动度、缓解疼痛、改善踝关节功能, 术后并发症较少, 具有良好的近期临床疗效。 展开更多
关键词 距骨 关节镜 富血小板血浆 踝关节
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Stratified-structural hydrogel incorporated with magnesium-ion-modified black phosphorus nanosheets for promoting neuro-vascularized bone regeneration 被引量:10
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作者 Yan Xu Chao Xu +7 位作者 Lei He Junjie Zhou Tianwu Chen Liu Ouyang Xiaodong Guo Yanzhen Qu Zhiqiang Luo deyu duan 《Bioactive Materials》 SCIE 2022年第10期271-284,共14页
Angiogenesis and neurogenesis play irreplaceable roles in bone repair.Although biomaterial implantation that mimics native skeletal tissue is extensively studied,the nerve-vascular network reconstruction is neglected ... Angiogenesis and neurogenesis play irreplaceable roles in bone repair.Although biomaterial implantation that mimics native skeletal tissue is extensively studied,the nerve-vascular network reconstruction is neglected in the design of biomaterials.Our goal here is to establish a periosteum-simulating bilayer hydrogel and explore the efficiency of bone repair via enhancement of angiogenesis and neurogenesis.In this contribution,we designed a bilayer hydrogel platform incorporated with magnesium-ion-modified black phosphorus(BP)nanosheets for promoting neuro-vascularized bone regeneration.Specifically,we incorporated magnesium-ion-modified black phosphorus(BP@Mg)nanosheets into gelatin methacryloyl(GelMA)hydrogel to prepare the upper hydrogel,whereas the bottom hydrogel was designed as a double-network hydrogel system,consisting of two interpenetrating polymer networks composed of GelMA,PEGDA,andβ-TCP nanocrystals.The magnesium ion modification process was developed to enhance BP nanosheet stability and provide a sustained release platform for bioactive ions.Our results demonstrated that the upper layer of hydrogel provided a bionic periosteal structure,which significantly facilitated angiogenesis via induction of endothelial cell migration and presented multiple advantages for the upregulation of nerve-related protein expression in neural stem cells(NSCs).Moreover,the bottom layer of the hydrogel significantly promoted bone marrow mesenchymal stem cells(BMSCs)activity and osteogenic differentiation.We next employed the bilayer hydrogel structure to correct rat skull defects.Based on our radiological and histological examinations,the bilayer hydrogel scaffolds markedly enhanced early vascularization and neurogenesis,which prompted eventual bone regeneration and remodeling.Our current strategy paves way for designing nerve-vascular network biomaterials for bone regeneration. 展开更多
关键词 Angiogenesis NEUROGENESIS Bone regeneration HYDROGEL Black phosphorus
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