Background：Bibliometric analysis and visualization tools were used to determine the development trend of intra-articular injection in arthroscopic treatment in the past 20 years, so as to guide researchers to explore new directions and hotspots in the field in the future. Method：In the Web of Science Core Collection, all articles about the application of intra-articular injection in arthroscopic treatment from 2000 to 2024 were searched. The qualitative and quantitative analysis was performed based on Web of Science, Vosviewer and Citespace software. Result：After excluding non-article articles such as review and letter and non-English language articles, 1007 articles were finally included. Over the past 2 decades, the number of publications on the application of intra-articular injection in arthroscopic treatment increased. Among them, the United States, China, the United Kingdom and Italy have made significant contributions in this field. The most productive institution was Rush University. The Journal of Arthroscopic and Related Surgery published the largest number of publications. The journal with the highest citation frequency also was The Journal of Arthroscopic and Related Surgery. The authors with the highest output and the highest citation frequency on average were Cole, Brian J and Choi, Yun-Jin, respectively. “arthroscopy”, “osteoarthritis” and “cartilage” were the top three keywords that appeared. From the keyword analysis, the current research trend indicates that the primary research hotspots of intra-articular injection in arthroscopic treatment are the arthroscopy, osteoarthritis and cartilage. The frontiers of this field are the Pain Management, osteoarthritis and Cartilage repair and regeneration. Conclusion：Over the past 23 years, the application of intra-articular injection in arthroscopic treatment has received increasing attention. Our bibliometric analysis results provide valuable information and research trends for researchers in the field to understand the basic knowledge of the field, identify current research hotspots, potential collaborators, and future research frontiers.

目的 探讨自体脂肪间充质干细胞(adipose tissue mesenchymal stem cells,AT-MSC)联合透明质酸治疗盘源性腰痛的效果.方法 选择2018 年1 月～2019 年6 月在本院就诊的104 例CDLBP患者作为研究对象,采用随机数字表法将患者分为对照组和观察组各52 例.对照组给予射频热凝术治疗,观察组给予AT-MSC联合透明质酸(hyaluronic acid,HA)椎间盘内注射治疗.观察两组患者术后并发症发生率和有效率,观察两组患者术前、术后1～12 个月时的VAS评分、Oswestry功能障碍指数(Oswestry disability index,ODI).结果 术后1～12 个月时,两组患者VAS和ODI均较术前显著降低(P＜0.05);术后1 个月时,观察组VAS和ODI显著高于对照组(P＜0.05);术后3 个月、6 个月时,两组VAS和ODI差异无统计学意义(P＞0.05);术后9 个月、12 个月时,观察组VAS和ODI显著低于对照组(P＜0.05).观察组 12 个月时,VAS降低≥50%、ODI改善≥50%所占比例和有效率均显著高于对照组(P＜0.05).两组患者术后并发症发生率差异无统计学意义(P＞0.05).结论 AT-MSC治疗CDLBP具有良好的中远期效果,值得进一步研究探讨.

目的:研究锁定钢板治疗肱骨近端骨折的疗效及患者年龄、Neer分型与疗效指标(Constant-Murley肩关节功能评分、X线片参数)的相关性.方法:回顾性分析经肱骨近端解剖锁定钢板内固定治疗的80例肱骨近端骨折患者临床资料,随访1年,分析年龄、Neer分型与Constant-Murley肩关节功能评分及X线片参数的关系.结果:年龄>60岁组术后Constant-Murley肩关节功能评分、颈干角、内翻角、颈干角内翻复位率低于年龄≤60岁组,前者肱骨大结节至钢板顶点的距离更大(P<0.05);Neer分型优良组术后Constant-Murley肩关节功能评分、颈干角、内翻角高于可差组,前者肱骨大结节至钢板顶点的距离更小(P<0.05);年龄与Constant-Murley评分、肱骨大结节至钢板顶点的距离呈独立负相关,而术后Neer评分与颈干角、内翻角、Constant-Murley评分呈独立正相关(P<0.05).结论:锁定钢板治疗肱骨近端骨折患者术后肩关节功能与X线片参数有明显相关性,具有一定的监测意义.

目的 探讨不同手术入路治疗GartlandⅢ型肱骨髁上骨折患儿的临床疗效.方法 回顾性分析2016年3月至2020年1月医院收治的64例GartlandⅢ型肱骨髁上骨折患儿的临床资料,根据手术入路的不同将其分为试验组(33例)与对照组(31例).试验组采取肘前横切口入路,对照组采取肘后正中切口肌间隙入路,比较两组的临床疗效.结果 术后两组均随访6个月以上,患儿骨折均愈合良好,末次随访无明显肘内翻畸形、肘关节伸屈功能障碍、骨化性肌炎、感染等并发症发生;两组术后优良率比较,差异无统计学意义(P>0.05);试验组术中出血量、手术时间、术后视觉模拟评分法(VAS)评分、瘢痕挛缩发生率均优于对照组,差异有统计学意义(P<0.05).结论 肘后正中切口肌间隙入路与肘前横切口入路治疗GartlandⅢ型肱骨髁上骨折患儿均可取得明显的效果,但后者可减少术中出血量、缩短手术时间、减轻术后疼痛、降低瘢痕挛缩发生率.

目的:探讨应用负压封闭引流(vacuum sealing drainage,VSD)技术联合腓肠神经营养血管皮瓣修复术治疗小腿Gustilo Ⅲ型骨折的临床疗效.方法:选取2012-05～2019-09收治的小腿Gustilo Ⅲ型骨折软组织缺损患者17例,车祸碾压伤13例,机器挤压、绞伤4例,其中Gustilo ⅢB型8例,Gustilo ⅢC型9例,均合并骨质外露及不同程度污染,均Ⅰ期行清创术+VSD,择期根据创面恢复情况行腓肠神经营养皮瓣修复术修补缺损创面,术后观察治疗效果.结果:17例患者术后随访10～21个月(平均13.4个月),皮瓣全部成活,外形美观,无迟发感染等并发症发生.14例经外固定架固定后骨折愈合时间为10～13个月(平均11.3个月),3例发生骨折不愈合,分别于术后7～8个月行植骨、髓内钉内固定术后愈合.结论:VSD联合腓肠神经营养血管皮瓣治疗小腿Gustilo Ⅲ型骨折软组织缺损,可减轻患者痛苦,减少医疗工作量,降低感染率和提高皮瓣成活率,是一种理想的小腿软组织修复方法.

目的 研究应用关节镜微创技术治疗膝关节骨创伤患者的临床效果.方法 方便选取该院自2019年10月—2020年10月收治的76例膝关节骨创伤患者,按照电脑随机的方式进行分组,每组38例.给予参照组常规治疗,给予观察组关节镜微创技术治疗,对比两组患者治疗效果、各项指标、疼痛评分和膝关节功能评分.结果 对比治疗效果,观察组治疗有效率为97.37％,明显高于参照组,差异有统计学意义(χ2=4.537,P<0.05);对比各项指标,观察组患者手术时间、术中出血量和骨折愈合时间明显优于参照组,差异有统计学意义(t=19.486、17.079、10.753,P<0.001);对比疼痛评分和膝关节功能评分,观察组各项评分明显优于参照组,差异有统计学意义(t=6.640、13.496,P<0.001).结论 在为膝关节骨创伤患者治疗时,应用关节镜微创技术,能够将疗效提升,缓解疼痛和改善膝关节功能,加快骨折愈合速度,让患者尽早地恢复到正常生活中,减少疾病为患者带来的痛苦,值得推广和应用.

目的:观察膝关节骨性关节炎应用关节镜下清理联合钻孔减压术治疗的效果.方法:选取2019年1月—12月,我院骨科接诊的72例膝关节骨性关节炎患者,根据信封法分为对照组和观察组,每组36例,对照组接受关节镜下清理术治疗,观察组接受关节镜下清理术联合钻孔减压术治疗,对比两组膝关节骨性关节炎患者的治疗效果.结果:观察组行走功能评分(9.92±1.05)分、休息疼痛评分(1.03±0.53)分、行走疼痛评分(3.15±1.11)分均优于对照组(7.25±0.83)分、(2.35±0.73)分、(5.06±1.02)分,差异具有统计学意义(P<0.05).观察组治疗总有效率(100.00％)高于对照组(86.11％),差异具有统计学意义(P<0.05).结论:膝关节骨性关节炎应用关节镜下清理术结合钻孔减压术治疗可以取得显著成效,值得在临床中应用.

目的 系统评价CT引导经皮微创技术与开放手术治疗脊柱结核的临床疗效和安全性.方法 计算机检索中国期刊全文数据库、中国生物医学文献数据库、万方数据库(1993-01/2014-10)、Cochrane Library、MEDLINE、EMBASE、SCI、PubMed.搜集有关CT引导经皮微创技术与开放手术治疗脊柱结核的随机对照试验和临床对照试验,采用Cochrane协作网专用软件Rev Man 5.3对数据进行Meta分析.结果 最终纳入15篇文献,共计1234例患者进行分析研究.Meta分析结果显示:CT引导经皮微创技术与开放手术在术后脊柱结核复发率、并发症发生率、术中出血量、椎体骨性融合时间、手术操作时间及住院时间方面差异有统计学意义(均P<0.05).结论 CT引导经皮微创技术治疗脊柱结核,与开放手术比较,可降低复发率和并发症发生率,减少术中出血量,缩短椎体骨性融合时间、手术操作时间及住院时间,是一种有效的微创术式,值得临床广泛推广应用.

Objective:Explore the operation effects of using posterior micro-endoscopic discectomy to treat lumbar disc herniation.Methods:140 cases who had lumbar disc herniation from Tenth Hospital of PLA be-tween 2012 June and 2014 January were random assigned,one group were given posterior micro-endoscopy discecto-my,one group were treated by intervertebral fenestration discectomy.Analysis the operation effect,adverse reaction and Oswestry disability index.Results:The average activity days of group MED was 3.5±4.5,The average hospi-talization days of group MED was 6.5±1 1,the average operation time of group MED was (45±20)min,the aver-age bleeding quantity of group MED was (60 ± 20)ml.These indexes were better than those of group interverte-bral fenestration discectomy.The rate of MED’s Macnab score were 91.1%,The score of postoperative’s Oswestry disability index is better than preoperative.Conclusion :Posterior micro-endoscopy discectomy is good at treating lumbar disc herniation and it has prospect in clinical for further use and promotion.

Objective To summarize the experience of treatment of severe thoracic crushed trauma complicated with acute respiratory distress syndrome(ARDS).Methods Early preventive measures and comprehensive therapeutic schemes were taken for the 16 patients with severe thoracic crushed trauma complicated with ARDS.Results All the 16 patients recovered completely,without any infection of thoracic cavity.Conclusion Application of early preventive measures and focused,accurate,timely integrated therapeutic schemes will help achieve satisfactory results in treatment of patients with severe thoracic crushed trauma complicated with ARDS.

胫骨疲劳性骨折是部队训练中常见损伤,发生后疼痛肿胀明显且症状持续时间长,传统治疗需患肢制动或石膏外固定4～6周,严重影响部队训练和生活.2001-01～2006-05,我们采用单边式外固定架治疗胫骨疲劳性骨折22例,取得良好效果.现报告如下.

目的:了解步兵、空军和装甲兵3兵种平时训练伤流行病学特征,对其病因进行比较分析。方法:参照《军事训练伤诊断标准及防治原则》,对训练伤1910例从兵种、年龄、损伤部位及性质进行比较分析。结果:(1)步兵年均发生率为4.7%,装甲兵2.5%,空军2.3%,步兵与空军、装甲兵比较,差异显著(P<0.05)。(2)17~22岁组训练伤发生率为62.9%。(3)急性创伤性损伤以骨折多见,慢性疲劳性损伤以腰部劳损多见。(4)3兵种训练伤发生率均以下肢损伤最高,腰部损伤次之。结论:步兵的急性损伤和慢性疲劳性损伤发生率最高,步兵比空军和装甲兵更易发生训练损伤。

胫骨结节骨软骨炎,是步兵战士常见病、多发病,尤其在新兵训练时,发病率较高.发病时胫骨结节处肿胀疼痛,伸膝乏力,严重影响部队训练工作正常进行.2001-10～2005-06我们收治步兵胫骨结节骨软骨炎43例,现报告如下.