Viens-Bitker C, de Pouvourville G, Poulin D, Morgon E, Blum-Boisgard C
Service Evaluation des Technologies Nouvelles, Paris.
Ann Urol (Paris). 1989;23(6):470-5.
A technology assessment of ESWL for renal stones has been conducted. The development of lithotripsy during the early phase of diffusion of the technique was studied retrospectively for 1985 and 1986. This study permitted the comparison of lithotripsy practice in Paris with that in Lyon. Results show that the proportion of small (less than 10 mm) stones increased from 39% at the beginning of the period to 60% at the end in Paris and simultaneously from 41% to 53% in Lyon. The location of the calculi treated by ESWL changed significantly over the period, but only in Paris where the number of caliceal stones went from 62% to 38% and that of ureteral stones from 1% to 8%. Neither the number of stones treated during one ESWL session, nor the length of hospital stay, changed significantly during the first years of use of this treatment. However, if one excludes hospital stays of more than 15 days, the average hospital stay in Paris decreased where as the opposite was observed in Lyon. The impact of the organization of ESWL users upon medical practice is obvious in relation to the size of stones: in Lyon, where one team provides ESWL therapy for all hospital urology departments, treatment practice is more homogeneous than in Paris and more closely a resembles the international consensus.
已对体外冲击波碎石术（ESWL）治疗肾结石进行了技术评估。回顾性研究了1985年和1986年该技术在早期传播阶段的碎石术发展情况。这项研究使得能够比较巴黎和里昂的碎石术实践。结果显示，小结石（小于10毫米）的比例在巴黎从该时期开始时的39%增加到末期的60%，同时在里昂从41%增加到53%。在此期间，接受ESWL治疗的结石位置发生了显著变化，但仅在巴黎，肾盂结石数量从62%降至38%，输尿管结石数量从1%增至8%。在该治疗使用的最初几年里，单次ESWL治疗的结石数量以及住院时间均未发生显著变化。然而，如果排除住院时间超过15天的情况，巴黎的平均住院时间缩短，而在里昂则出现相反情况。就结石大小而言，ESWL使用者的组织形式对医疗实践的影响是明显的：在里昂，由一个团队为所有医院泌尿外科提供ESWL治疗，其治疗实践比巴黎更具同质性，且更接近国际共识。
