Acute pancreatitis is one high-incidence acute abdominal condition, which is closely related to dietary habits and lifestyle. Patients' compliance with medical advice also directly affects treatment effect and prognosis. There are some studies on compliance in patients with acute pancreatitis, but little attention has been paid to its association with recurrence.

To investigate the factors associated with compliance with medical advice and the association between compliance and recurrence in patients with acute pancreatitis.

By use of convenience sampling, four grade A tertiary hospitals in Shijiazhuang City (The First Hospital of Hebei Medical University, the Second Hospital of Hebei Medical University, the Third Hospital of Hebei Medical University, and the Fourth Hospital of Hebei Medical University) were selected as survey settings, in which patients with acute pancreatitis treated from 2019 to 2021 were selected as the subjects. Then the patients were surveyed using a self-designed questionnaire for investigating their demographics, awareness level of acute pancreatitis, and health belief during the three days prior to discharge, and were followed up by telephone at 3, 6, and 12 months after the questionnaire survey for acquiring the recurrence. They also attended another survey using a self-designed questionnaire at the last telephone follow-up for understanding their compliance.

In all, 100 cases attended the survey, 97 of them (97.0%) who effectively responded to the survey were included for final analysis. Among the 97 respondents, 62 (63.9%) were fully compliant, 27 (27.8%) partially compliant, and 8 (8.3%) non-compliant. Multivariate Logistic regression analysis showed that gender〔OR=9.393, 95%CI (1.909, 46.223) 〕, age〔OR=1.048, 95%CI (1.000, 1.099) 〕, education level 〔OR=0.572, 95%CI (0.333, 0.985) 〕, and awareness level of acute pancreatitis〔OR=0.902, 95%CI (0.834, 0.976) 〕 were associated with compliance in patients with acute pancreatitis (P<0.05) . During the 12 months of follow-up, 41 patients (42.3%) relapsed and 56 (57.7%) did not. There was a statistically significant difference in compliance of patients with and without recurrence (χ²=7.082, P=0.029) . Multivariate Logistic regression analysis showed that male 〔OR=10.798, 95%CI (1.034, 112.781) 〕, alcohol consumption〔OR=16.546, 95%CI (1.310, 209.049) 〕, cholelithiasis〔OR=8.502, 95%CI (1.694, 42.673) 〕, hyperlipidemia〔OR=5.287, 95%CI (1.098, 25.450) 〕, partial compliance〔OR=0.115, 95%CI (0.014, 0.947) 〕, and noncompliance〔OR=0.036, 95%CI (0.003, 0.513) 〕 were risk factors for the recurrence of acute pancreatitis (P<0.05) .

The factors affecting the compliance of patients with acute pancreatitis include gender, age, educational level, and awareness of acute pancreatitis, and compliance may be a key associated factor of the recurrence rate. Therefore, to reduce the development and recurrence of acute pancreatitis, it is suggested to take actions in accordance with the associated factors of compliance to promote relevant health education to improve patients' compliance with medical advice and ability of self-management. In addition, actions should be taken to reduce the influence of risk factors of recurrence of acute pancreatitis, such as improving unhealthy eating habits, quitting drinking, actively treating hyperlipidemia and other underlying diseases, and curing cholelithiasis and other predisposing factors as soon as possible.

急性胰腺炎是临床高发急腹症之一，其与饮食习惯和生活方式密切相关，患者对医嘱的依从情况直接影响其疗效和预后。目前对于急性胰腺炎患者的依从性已有一些研究，但对于其与复发情况的相关性研究较少。

调查急性胰腺炎患者遵医嘱依从性的影响因素及其对复发情况的影响。

采用便利抽样法，选择石家庄市4家三级甲等医院（河北医科大学第一医院、河北医科大学第二医院、河北医科大学第三医院、河北医科大学第四医院）作为调查场所，选取2019—2021年该4家医院收治的急性胰腺炎患者为调查对象。在患者出院前3 d，采用自行设计的问卷调查患者的基本资料、疾病知晓度和健康信念；在问卷填写后3、6、12个月进行电话随访调查患者的复发情况；在第12个月进行电话随访时，采用自行设计的问卷调查患者的依从性。

共发放问卷100份，回收问卷100份，有效问卷97份，有效回收率为97%。97例患者中完全依从62例（63.9%）、部分依从27例（27.8%）、不依从8例（8.3%）。多元Logistic回归分析结果显示，性别〔OR=9.393，95%CI（1.909，46.223）〕、年龄〔OR=1.048，95%CI（1.000，1.099）〕、文化程度〔OR=0.572，95%CI（0.333，0.985）〕、疾病知晓度〔OR=0.902，95%CI（0.834，0.976）〕是急性胰腺炎患者依从性的影响因素（P<0.05）。随访12个月内，97例患者中复发41例（42.3%），未复发56例（57.7%）。复发与未复发者依从性比较，差异有统计学意义（χ²=7.082，P=0.029）。多元Logistic回归分析结果显示，男性〔OR=10.798，95%CI（1.034，112.781）〕、饮酒〔OR=16.546，95%CI（1.310，209.049）〕、胆石症〔OR=8.502，95%CI（1.694，42.673）〕、高脂血症〔OR=5.287，95%CI（1.098，25.450）〕、部分依从〔OR=0.115，95%CI（0.014，0.947）〕、不依从〔OR=0.036，95%CI（0.003，0.513）〕是急性胰腺炎患者复发的危险因素（P<0.05）。

急性胰腺炎患者依从性的影响因素为性别、年龄、文化程度和疾病知晓度，且依从性是影响复发率的重要因素，因此需要针对影响依从性的相关因素进一步完善健康教育以提高患者的依从性，增强其自我管理能力，以减少急性胰腺炎的产生与复发。同时应从影响复发情况的因素入手，戒酒、改变不良的饮食习惯、积极治疗基础疾病如高脂血症、尽早治愈诱发因素如胆石症等。