感染性骨缺损的治疗因“感染-修复”恶性循环而面临巨大挑战。抗菌-成骨双功能水凝胶通过协同整合抗菌与成骨功能，为破解这一难题提供了创新策略。此文综述了该类水凝胶在骨髓间充质干细胞骨修复中协同作用的最新研究进展，重点阐述了赋予材料智能化功能的设计策略，深入剖析了时序协同、微环境重塑和空间协同等核心机制。通过物理抗菌、免疫调节、智能释药等多维度机制的协同，可有效调控骨髓间充质干细胞活性，打破感染抑制骨再生的恶性循环。尽管水凝胶的临床前疗效明显，但其临床转化仍面临微环境响应性不足、功能协同矛盾及生物安全性等挑战。未来研究需聚焦于智能载体开发及时空序贯释放体系构建，以推动骨再生策略向智能化、精准化发展。

The treatment of infectious bone defects faces great challenges due to the “infection-repair” vicious cycle. Antibacterial-osteogenic bifunctional hydrogels provide an innovative strategy to solve this problem by synergistically integrating antibacterial and osteogenic functions. This article reviews the latest research progress on the synergistic effect of this type of hydrogel in bone repair of bone marrow mesenchymal stem cells (BMSCs), focuses on design strategy giving the material intelligent function, and analyzes its core synergy mechanism including temporal synergy, microenvironment remodeling and spatial collaboration. The function of BMSCs is coordinated through multi-dimensional mechanisms such as physical antibacterial, immunomodulation, and intelligent drug release, effectively breaking the vicious circle of infection inhibiting bone regeneration. Although preclinical studies have shown significant efficacy, its clinical translation still faces challenges such as insufficient microenvironment response, function synergy contradiction, and biosafety. Future research needs to focus on the development of intelligent carriers and the construction of spatiotemporal sequential release systems, so as to promote bone regeneration strategies to be more intelligent and precise.