Abstract: Objective To investigate the effect of exchange transfusion（ET）performed for neonatal hyperbilirubinemia. Methods A total of 94 neonates received ET in our hospital between January 2018 and September 2020 were included. Demographic characteristics,blood indexes before and after ET,and adverse reactions in neonates were recorded. Results Ninety-four neonates underwent ET had significantly increased levels of indirect bilirubin, including 28 （29.8%） ABO HDN,14（14.9%） intracranial hemorrhage and cephalohematoma,13（13.8%） neonatal sepsis and other infections,7（7.4%） glucose 6-phosphate dehydrogenase（G-6-PD）deficiency,4（4.3%） Rh hemolysis,3 （3.2%）polycythemia,and 25 （26.6%） hyperbilirubinemia due to other causes. The levels of total bilirubin and indirect bilirubin,direct bilirubin,total protein and albumin,ALT,AST,GGT and ALP,creatinine,urea,CysC,LDH,CK, CK-MB After ET were significantly decreased than those before ET（P<0.05）. WBC count,hematocrit,hemoglobin and platelet count were significantly lower than those before ET（P<0.05）. The levels of pH,HCO3-,BE,Na+ and Cl-, and Ca2+ were significantly lower than those before ET（P<0.05）,but pO2,K+,glucose,lactic acid,PT,INR after ET were higher than those before ET （P<0.05）. No significant differences were found in URIC,pCO2,RBC count and APTT before and after ET（P>0.05）. After ET,there were 33 hypocalcemia,55 thrombocytopenia,83 hyperglycemia,41 metabolic acidosis and 5 cases of hyperkalemia. Conclusion ET is an effective treatment for treat neonatal hyperbilirubinemia due to removal of serum bilirubin,but it can cause significant changes in some blood indexes and adverse reactions after ET. The changes of blood indexes and clinical manifestations should be carefully monitored during ET so as to ensure safety and efficacy of ET.

Key words: Neonatal hyperbilirubinemia, Exchange transfusion, Curative effect, Adverse reactions