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目的：明确右美托咪定及咪达唑仑对重型颅脑外伤患者血流动力学的影响及镇静效果。方法选取EICU收治的重型颅脑外伤患者98例，随机分为两组，右美托咪定组（D组）49例及咪达唑仑组（M组）49例。D组患者采用静脉泵入右美托咪定镇静治疗，M组患者采用静脉泵入咪达唑仑镇静，记录两组患者用药前及用药后5、30、60、120 min的心率、血压、血氧饱和度，并评估不同时间点的Ramsay镇静评分。结果 D组患者在镇静前后各个时间点的心率、舒张压、脉氧维持稳定（P>0.05），M组患者的血流动力学参数则波动明显（P<0.05），且D组患者镇静后30、60 min的Ramsay镇静评分均大于M组（P0.05). The hemodynamic parameters in patients of group M were obvious fluctuated (P<0.05). Ramsay sedation score after 5 minutes,30 minutes, 60 minutes of sedation in patients of group D were higher than group M(P <0.05). Conclusion Dexmedetomidine carries out a feature of an obvious sedation effect than Midazolam for patients who suffer from severe traumatic brain injury and a little effect on their hemodynamics.