Objective To explore the application value of near-infrared spectroscopy (NIRS) monitoring in the monitoring of tissue perfusion in the distal lower extremity and in the revascularization.

Methods From August 2021 to October 2022, 60 patients who were hospitalized in the Department of Vascular Surgery of the Second Affiliated Hospital of the Naval Military Medical University and were clinically diagnosed as arteriosclerosis obliterans of the lower extremity and underwent lower extremity revascularization were retrospectively selected. The patients were divided into NIRS group (n=30) and non-NIRS group (n=30) according to whether to use near-infrared spectroscopy monitoring during operation. NIRS group was further divided into T2DM subgroup (n=13) and non T2DM subgroup (n=17) according to whether the patient had diabetes. The general data of patients were collected. In NIRS group, rSO₂ was monitored during perioperative period and the values of rSO₂ and ABI were recorded before and after operation. Record the details of the patient's operation, adverse events, secondary surgical intervention and other data.

Results There was no statistically significant difference in baseline data between NIRS group and non-NIRS group, with 5 (16.7%) and 3 (10.0%) adverse events respectively. After operation, rSO₂ and ABI in NIRS group were significantly higher than those before operation (P < 0.05), and there was a correlation between rSO₂ and ABI in affected limbs before and after operation (r=0.701, P < 0.001; r=0.548, P=0.002). After operation, rSO₂ and ABI in T2DM subgroup and non-T2DM subgroup were significantly higher than those before operation (P < 0.05). There was no statistically significant difference in rSO₂ and ABI between the two groups before operation. After operation, rSO₂ and ABI in non-T2DM group were significantly higher than those in T2DM group (P < 0.05). There was no correlation between rSO₂ and ABI before and after operation in T2DM subgroup (P=0.062, P=0.354), while there was correlation between rSO₂ and ABI before and after operation in non-T2DM subgroup (r=0.767, P < 0.001; r=0.688, P=0.002).

Conclusions NIR monitoring can reflect the oxygenation and perfusion of lower limb tissue through the level and change of rSO₂, which has certain guiding significance for the drug application during surgical diagnosis and treatment and follow-up. In the perioperative period of lower limb artery reconstruction, sudden adverse events can be found immediately, which can guide the adjustment of treatment measures, improve the prognosis and reduce the occurrence of related complications.