火器伤远达效应发生率高 ,但伤情隐蔽 ,临床医生较为陌生 ,容易误诊误治〔1〕。远达效应病变虽不会立即威胁伤员生命 ,在某些条件下却可成为伤后早期并发证发生发展的病理基础 ,从而使全身伤情加重 ,引起严重的临床后果〔2〕。远达效应的损伤表现、发生规律、发生机制复杂多样 As the incidence of firearm injuries as high as the effect, but the injury covert, clinicians more unfamiliar, easy misdiagnosis and mistreatment 〔1〕. Although the effects of REM can not immediately threaten the life of the wounded, it may become the pathological basis for the occurrence and development of the early post-injury syndrome under certain conditions, thereby aggravating the systemic injury and causing serious clinical consequences (2). As far as the effect of damaging performance, the occurrence of the law, the mechanism is complex and diverse