The invention discloses a hydraulic power heat exchange device used for an air conditioner cold-hot water unit and the air conditioner cold-hot water unit. The hydraulic power heat exchange device comprises a chilled water heat exchanger, a heat exchange assembly and a control unit, wherein the first end and the second end of the chilled water heat exchanger are correspondingly connected with thewater inlet end and the water outlet end; the heat exchange assembly comprises first to sixth ports; the first port and the second port are correspondingly connected with the third end and the fourthend of the chilled water heat exchanger; the third port and the fourth port are correspondingly connected with a low-pressure pipeline and a high-pressure pipeline of an outdoor unit; the fifth port and the sixth port are correspondingly connected with the first end and the second end of an indoor unit; and the control unit controls reversing of a four-way valve and communication among the ports of the heat exchange assembly so that the air conditioner cold-hot water unit can run under different working modes. Thus, the unit can achieve multi-function operation, and the hydraulic power heat exchange device is simple in structure, low in cost and easy to install.