[The management for pediatric chronic rhinosinusitis with upper respiratory tract concomitant diseases]

Objective:To analyze the clinical impact of upper respiratory tract concomitant diseases in pediatrics chronic rhinosinusitis(CRS) and treatment methods, efficacy and timing of the concomitant diseases.Method:Two hundred and sixty-seven cases with CRS at a tertiary children's medical center from March 2013 to March 2015 were included in this study. The cases were divided into two groups according to the concomitant diseases. 66 cases without concomitant diseases were allocated into group A；201 cases with concomitant diseases were classified into group B. Group B was further divided into two subgroups according to treatment methods: subgroup B1(97 cases) and subgroup B2(104 cases). Group A and B1 were given the same basic treatment for 3 months，while Group B2 was given the basic plus targeted treatment for the same duration. Comprehensive evaluation was conducted at 3, 6 and 15-months after commencement of treatment. Result:The therapeutic effect of Group A was significantly superior to Group B1 in 3 months（P<0.05）.The clinical efficacy of Group A decreased slightly while Group B1 showed significantly reduced efficacy at 6 and 15-months （all P<0.05）. Comparing Group B1 and B2, the comprehensive effect of Group B2 was considerably better than Group B1 at 3 months（P<0.05）. Furthermore, Group B2 showed no decrease in efficacy while Group B1 decreased significantly at 6 and 15-month. Conclusion:Recurrent upper respiratory tract infections, allergic rhinitis, adenoid hypertrophy and chronic tonsillitis, were common the upper respiratory tract accompanying diseases in children with CRS, and they had significant influence on the efficacy and recurrence of CRS. The basic plus targeted treatment can improve the efficacy and reduce recurrence.