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目的:探讨改良外周动静脉全自动同步换血疗法治疗新生儿重度高胆红素血症的疗效和安全性。方法:选择2016年1月至2019年12月在淮南市妇幼保健院新生儿科换血治疗的新生儿重度高胆红素血症患儿25例为研究对象，换血时建立两条通路，一条动脉通路为放血通路，另一条外周静脉为输血通路(该通路由留置针连接佳士比3000输液泵专用输血皮条，此皮条过滤器上端呈Y型，有两根平行的输血穿刺器，分别插入红细胞血袋和血浆血袋，共用一个过滤器输血。每输入100 mL红细胞，夹闭红细胞血袋端皮条，开放血浆血袋端皮条，再输入50 mL血浆，交替进行)，两条动静脉形成换血回路，由3个输液泵控制(第1泵为放血泵，第2泵为输血泵，第3泵为肝素钠输注泵)，真正实现了全程全自动换血。观察换血前后血常规、血总胆红素、血气分析、血糖、电解质、血培养及生命体征变化。结果:25例患儿中，换血时间90～120 min。换血前后呼吸、心率、血压、电解质、血气分析变化均差异无统计学意义(均n P>0.05)；换血前后血清总胆红素、血小板均明显下降[换血前后总胆红素(485.8±126.5)μmol/L比(207.9±68.4)μmol/L；换血前后血小板(301.6±118.3)×10n 9/L比(125.3±60.2)×10n 9/L，n t＝－6.924、－7.986，均n P<0.01]；换血后白细胞较换血前下降[换血前(12.57±6.11)×10n 9/L，换血后(8.98±3.24)×10n 9/L，n t＝－2.922，n P<0.05]；换血后微量血糖高于正常值，与换血前差异有统计学意义[换血前(4.9±0.7)mmol/L，换血后(7.1±1.5)mmol/L，n t＝3.866，n P0.05), while the serum TBIL and platelets(PLT) levels were significantly decreased[the amount of TBIL before and after blood transfusion: (485.8±126.5)μmol/L vs.(207.9±68.4)μmol/L; the amount of PLT before and after blood transfusion: (301.6±118.3)×10n 9/L vs.(125.3±60.2)×10n 9/L] (n t=-6.924, n P<0.01;n t=-7.986, n P<0.01), and white the blood cells(WBC) was decreased [before blood transfusion: (12.57±6.11)×10n 9/L, after blood transfusion: (8.98±3.24)×10n 9/L, n t=-2.922, n P<0.05]. The trace blood glucose(TBG) was higher than normal after blood transfusion, with a significant change[before blood transfusion: (4.9±0.7)mmol/L, after blood transfusion: (7.1±1.5)mmol/L,n t=3.866, n P<0.01]. TBG restored within 24 h after exchange transfusion, PLT and WBC backed to normal within 72 h. Blood bacterial culture was negative in all cases after the exchange transfusion.No serious complications occurred and all patients were cured.n Conclusion:It is simple, safe and reliable to treat severe neonate hyperbilirubinemia by the peripheral automatic exchange transfusion controlled by infusion pumps.The treatment is worthwhile to be recommended for clinical use in primary hospitals.