| 周建红,吕辉,廖胜,等.“C”型臂引导下集成技术活检结合宏基因二代测序在脊柱感染病变中的应用价值.骨科,2025,16(5): 385-391. |
| “C”型臂引导下集成技术活检结合宏基因二代测序在脊柱感染病变中的应用价值 |
| The application value of integrated biopsy combined with metagenomics next generation sequencing technology in spinal infections under the guidance of C-arm |
| 投稿时间：2025-03-31 |
| DOI：10.3969/j.issn.1674-8573.2025.05.001 |
| 中文关键词: 脊柱感染性疾病 活检 集成技术 宏基因测序 |
| 英文关键词: Infectious diseases of spine Biopsy Integrated technology Metagenomics next generation sequencing |
| 基金项目:重庆市卫生健康委员会医学科研项目（2025WSJK015） |
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| 中文摘要: |
| 目的 探讨“C”型臂X线机引导下采用集成技术活检结合宏基因二代测序技术（mNGS）在脊柱感染性疾病中的应用价值。方法 选取2020年1月至2025年1月陆军第九五八医院收治的295例脊柱感染病人，其中男138例，女157例，年龄（51.98±13.45）岁（12~83岁）。病人均通过一期经“C”型臂引导下集成技术活检、二期开放手术时取样这两种方式获取病灶标本，并分别进行组织病理学检测和病原微生物学相关检测（抗酸染色、细菌涂片及培养、GeneXpert、mNGS、结核分枝杆菌快慢培养等），将两次结果进行对比分析，计算一致性，观察并发症发生等情况。结果 所有病人采用集成技术活检，无重复取材，样本充分率为100%，且术后未见确切并发症。一期取样的组织病理学检测结果有274例（92.88%）为阳性，二期开放手术取样检测的阳性率为93.22%，两次取样检测的阳性一致率为100%，阴性一致率为95.24%。一期取样的病原微生物学相关检测结果有280例（94.92%）为阳性，二期开放手术取样检测的阳性率为95.93%，两次取样检测的阳性一致率为100%，阴性一致率为80.00%。一期、二期取样的组织病理学及微生物学检测的阳性率比较，差异均无统计学意义（P＞0.05）。结论 “C”型臂X线机引导下采用集成技术进行病灶活检结合mNGS检测，与开放手术取材的检测结果具有高度一致性，值得临床推广应用。 |
| 英文摘要: |
| Objective To explore the application value of C-arm guided integrated biopsy combined with metagenomics next generation sequencing (mNGS) in spinal infectious diseases. Methods A total of 295 patients with spinal infections admitted to the 958th Hospital of the Army from January 2020 to January 2025 were selected, including 138 males and 157 females, aged (51.98±13.45) years (12-83 years). Lesion specimens were obtained through C-arm guided integrated biopsy in the first stage and open surgery in the second stage. The specimens obtained in both stages were subjected to histopathological test and pathogen microbiological tests (acid-fast staining, bacterial smear and culture, GeneXpert, mNGS, rapid and slow culture of Mycobacterium tuberculosis, etc.). The results of the two stages were compared and analyzed, and the consistency of the results was calculated, as well as the occurrence of complications was observed. Results All patients underwent integrated biopsy without repeated sampling, the sample adequacy rate was 100%, and no definite complication was observed. In the first stage, 274 cases (92.88%) were positive by histopathological test, while the positive rate of the second stage was 93.22%, the positive consistency rate of the two stages was 100%, and the negative consistency rate was 95.24%. Total of 280 cases (94.92%) were positive by pathogen microbiological tests in the first stage, and the positive rate of open surgery sampling testing in the second stage was 95.93%, the positive consistency rate of the two stage was 100%, and the negative consistency rate was 80.00%. There was no statistically significant difference in the positive rates of tissue pathology and microbiological testing between the first and second stage (P＞0.05). Conclusion C-arm guided integrated biopsy combined with mNGS has a high consistency with open surgery detection results and is worthy of clinical promotion and application. |
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