目的 系统分析护士主导的气管插管拔管后吞咽障碍管理方案，为急危重症患者拔管后吞咽困难的预防及管理提供参考。方法 根据范围综述的研究规范，系统检索Cochrane Library、PubMed、Embase、Web of Science等英文数据库，中国知网、万方数据库、中国生物医学文献数据库等中文数据库，检索期限为建库至2024年1月31日，筛选拔管后吞咽困难管理相关文献并进行系统综述分析。结果 共纳入22篇研究，其中2篇文献内容涉及拔管后吞咽障碍评估与干预两个方面；14篇文献内容仅涉及拔管后吞咽障碍的筛查与评估；6篇文献内容仅涉及拔管后吞咽障碍的预防与干预；拔管后吞咽障碍发生率为3%~54.2%；评估时机多从拔管后2~24 h开始，使用工具包括功能性口服摄入量表、重复性唾液吞咽测试等。部分研究联合多种工具筛查，阳性患者在24 h后接受1~2次复评，再转诊康复科或语言治疗师。预防及干预方法包括口腔运动、代偿策略、呼吸机力量训练、健康教育和冷喷雾治疗，干预多从拔管后24 h开始持续至少10 d或至出院。结论 护士主导的吞咽障碍管理具有可行性与安全性，能缩短经口进食等待时间、降低吸入性肺炎风险，并能弥补重症监护单元语言治疗师资源不足。然而，目前缺乏标准的评估与干预方案，评估时机、评估工具及干预方案存在异质性，需要高质量的临床研究为构建综合管理策略提供依据。

Objective To systematically analyze the nurse-led post-extubation dysphagia management program for tracheal intubation，and to provide a reference for the prevention and management of post-extubation dysphagia in patients with acute and critical illness. Methods According to the research specifications of scoping reviews，a systematic search was conducted in English databases including Cochrane Library，PubMed，Embase，Web of Science，and Chinese databases such as CNKI，Wanfang Data，and Chinese Biomedical Literature Database. The search period was from the establishment of the databases to January 31，2024. Relevant literature on the management of post-extubation dysphagia was selected and systematically reviewed. Results A total of 22 studies were included，of which 2 studies were related to the assessment and intervention of post-extubation dysphagia，14 studies related to the screening and assessment of post-extubation dysphagia，6 studies related to the prevention and intervention of post-extubation dysphagia. The prevalence rate of post-extubation dysphagia ranged from 3% to 54.2%，the timing of assessment was mostly started 2-24 h after extubation，and the tools used included Functional Oral Intake Scale，Repetitive Saliva Swallowing Test，etc. Some studies combined multiple tools for screening，and positive patients received 1 or 2 reassessments at 24 h before referral to rehabilitation or speech therapist. Prevention and intervention methods included oral exercises，compensatory strategies，ventilator strength training，health education，and cold spray therapy，with interventions mostly starting 24 h after extubation and continuing for at least 10 d or until discharge. Conclusion Nurse-led dysphagia management is feasible and safe，reduces the waiting time for oral feeding，decreases the risk of aspiration pneumonia，and compensates for the lack of resources for speech therapists in the ICU. However，there is a lack of standardized assessment and intervention protocols，and there is heterogeneity in the timing of assessment，assessment tools，and intervention protocols. High-quality clinical trials are needed to inform the development of comprehensive management strategies.