Abstract: Objective To systematically evaluate the effect of bundle arm compression exercise on maturation of arteriovenous fistulas (AVF) after surgery.  Methods  A systematic search in CNKI, Wanfang, VIP, SinoMed, PubMed, Embase, Cochrane Library, and Web of Science databases was conducted for randomized controlled trials (RCTs) and quasi-experimental studies to evaluate bundle arm compression exercise on maturation of AVF after surgery. Data were analyzed using RevMan 5.4.1 software.  Results  A total of 10 studies involving 1,737 patients were included. Meta-analysis results showed that compared with the routine exercise group, bundle arm compression exercise significantly increased ultrasound AVF maturation rate (OR=2.50, 95% CI:1.94～3.22, P＜0.001), clinical AVF maturation rate (OR=2.85, 95% CI:1.73～5.68, P＜0.001) and first successful AVF puncture rate (OR=3.95, 95% CI:1.67～9.36, P=0.002), and decreased AVF-related complication rate (OR=0.21, 95% CI:0.10～0.44, P＜0.001). It also significantly increased AVF diameter (MD=2.50, 95% CI:1.94～3.22, P＜0.001) and AVF blood flow (MD=84.98, 95% CI:(60.87～109.09, P＜0.001), and decreased AVF maturation time (MD=-1.56, 95% CI:-1.97～-1.15, P＜0.001). There were no significant differences between the subgroups based on the time to initiate the exercise (3 days, 1 week, and 2 weeks after surgery), but the effective degree was the biggest in patients to initiate the exercise 3 days after surgery in terms of ultrasound AVF maturation rate, clinical AVF maturation rate, first successful AVF puncture rate and AVF maturation time.  Conclusion  Bundle arm compression exercise can promote AVF maturation and decrease the risks of AVF complications. We recommend the inclusion of bundle arm compression exercise beginning from 3rd days after AVF surgery in the routine nursing program.

Key words: Hemodialysis, Arteriovenous fistula, Arm compression exercise, Postoperative maturation