Abstract: Objective  To systematically evaluate the effect of ultrasound-guided cannulation of arteriovenous fistula (AVF) in hemodialysis patients.  Methods  The databases of PubMed, Embase, Cochrane Library, CNKI, VIP and Wanfang were searched for randomized controlled trials (RCTs) about the efficacy comparison between ultrasound-guided puncture and traditional blind puncture in AVF from the inception to October 2022. Meta-analysis was performed using Revman 5.0 and Stata 16.0 software.  Results  A total of 8 RCTs with 281 patients and 4992 punctures were included. Meta-analysis showed that ultrasound guidance could improve the success rate of one puncture (RR=1.12, 95% CI:1.05～1.20, P＜0.001), reduce the incidence of complications after puncture (RR=0.30, 95% CI:0.13～0.71, P=0.006), and extended the pre-puncture evaluation time (MD=75.26, 95% CI:68.16～82.36, P＜0.001); but the time for puncture (MD=12.91, 95% CI:-11.46～37.28, P=0.300) and pain perception (MD=-0.11, 95% CI:-0.67～0.45, P=0.710) had no statistical significance.  Conclusion  Compared with traditional blind puncture, ultrasound-guided AVF puncture can significantly improve the success rate of one puncture and reduce the incidence of complications. However, its impacts on puncture time, evaluation time and pain perception needs to be verified by further randomized controlled studies with larger samples.

Key words: Arteriovenous fistula, Ultrasound guidance, Cannulation, Hemodialysis