基于内镜操作细节记录系统构建胃底静脉曲张内镜下组织胶注射术（ECI）的标准化管理方案，探讨该方案在ECI疗效评估中的应用价值。

本研究对象为2019年10月至2021年10月在中山大学附属第三医院行ECI的110例肝硬化门静脉高压症胃底静脉曲张患者。其中男88例，女22例；平均年龄（53±11）岁。建立内镜操作细节记录系统，并构建内镜下肝硬化ECI规范化管理方案，包括日常培训、术前准备、术中操作要点、术中应急预案、术后随访等流程的操作规范。术后1个月复查胃镜情况等，评估治疗效果。

本研究建立了内镜操作细节记录系统，该系统不仅可详细记录组织胶用量、注射部位、注射点数、注射时间、注射针长度、注射针直径、注射后压迫时间等操作细节，还包括一次性成功、发生堵针、漏胶、黏胶、医师满意度等质量指标。患者ECI一针成功率98.2%（108/110）。术中不良事件发生率14.5%（16/110），其中单纯发生拔针后出血7例、漏胶3例、黏胶2例，同时发生漏胶合并黏胶2例，拔针后出血合并黏胶1例，拔针后出血同时合并漏胶、黏胶1例。术后早期再出血发生率3.6%（4/110），无发生迟发性出血。术后1个月82例获得随访，随访率74.5%（82/110）。ECI总有效率达87%（72/82），其中有效率59%（49/82），显效率28%（23/82）。

对于肝硬化ECI患者，应用内镜操作细节记录系统构建的规范化管理方案可以详细记录术中操作细节，规范操作流程，数字化分析失败原因，保证了内镜治疗操作的高成功率。

To establish a standardized management regimen for endoscopic cyanoacrylate injection (ECI) for gastric varices based on the endoscopic operation detail recording system, and to evaluate the application value of this regimen in the evaluation of ECI efficacy.

110 patients with gastric varices due to cirrhosis and portal hypertension who underwent ECI in the Third Affiliated Hospital ofSun Yat-sen University from October 2019 to October 2021 were enrolled. Among them, 88 patients were male and 22 female, aged (53±11) years on average. An endoscopic operation detail recording system was established. A standardized management regimen for liver cirrhosis ECI was established including daily training, preoperative preparation, intraoperative operation highlights, intraoperative emergency plan and postoperative follow-up, etc. At postoperative 1 month, gastroscopy was performed to evaluate the therapeutic effect.

In this study, an endoscopic operation detail recording system was established, which could not only record operation details such as the amount of cyanoacrylate, injection site, injection points, injection time, length of injection needle, diameter of injection needle and compression time after injection, but also included quality indexes such as one-time success rate, incidence rate of needle blockage, cyanoacrylate leakage, cyanoacrylate sticking and physician satisfaction degree, etc. The one-time success rate of ECI was 98.2% (108/110). The incidence of intraoperative adverse events was 14.5% (16/110), including 7 cases of bleeding, 3 cases of cyanoacrylate leakage and 2 cases of cyanoacrylate sticking, 2 cases of cyanoacrylate leakage combined with glue sticking, 1 case of bleeding combined with cyanoacrylate sticking, and 1 case of bleeding combined with cyanoacrylate leakage and sticking after needle extraction. The incidence of early postoperative re-bleeding was 3.6% (4/110), and no delayed bleeding occurred. 82 cases were followed up at postoperative 1 month, and the follow-up rate was 74.5% (82/110). The total effective rate of ECI was 87% (72/82). The effective rate was 59% (49/82) and the significantly effective rate was 28% (23/82).

For liver cirrhosis patients undergoing ECI, the standardized management regimen established by endoscopic operation detail recording system can record the operation details, standardize the operation process and digitally analyze the causes of failure, thereby ensuring high success rate of endoscopic treatment operation.