CN111493326A - Enteral nutrition food and preparation method and application thereof - Google Patents
Enteral nutrition food and preparation method and application thereof Download PDFInfo
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- CN111493326A CN111493326A CN202010348664.2A CN202010348664A CN111493326A CN 111493326 A CN111493326 A CN 111493326A CN 202010348664 A CN202010348664 A CN 202010348664A CN 111493326 A CN111493326 A CN 111493326A
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- parts
- powder
- puffed
- enteral
- oligosaccharide
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Abstract
The invention discloses an enteral nutritional food and a preparation method and application thereof, the enteral nutritional food comprises 10-40 parts of separated albumen powder, 5-18 parts of freeze-dried fruit powder, 5-20 parts of enzymolysis oat powder, 5-15 parts of MCT powder, 5-18 parts of whole milk powder, 10-30 parts of maltodextrin, 5-18 parts of microwave puffed grains, 3-10 parts of coconut powder, 2-8 parts of instant Ceylon black tea powder, 3-15 parts of solid malt extract, 2-5 parts of low methoxyl pectin, 1-12 parts of fructo-oligosaccharide, L-glutamine 1-5 parts, 0.6-4 parts of arginine, 3-20 parts of soybean oligopeptide, 0.71091-2.41419 parts of compound vitamin and 0.29103-0.52907 parts of compound mineral substance.
Description
Technical Field
The invention relates to a nutritional food, in particular to an enteral nutritional food and a preparation method and application thereof.
Background
For the postoperative patients of general surgery, the gastrointestinal functions of the patients are certain obstacles, and the bodies of the postoperative patients are often in high decomposition and high metabolism states, so that the demand of the bodies on energy is increased, various malnutrition phenomena are easy to occur, and the development and regression of diseases are easily influenced. Therefore, the administration of timely nutritional support and the maintenance of gastrointestinal function is very critical and important for the regulation of body immunity. In recent years, enteral nutrition (intestinal nutrition EN), particularly early enteral nutrition after surgery, has been regarded by clinicians, and it has been found in practice that enteral nutrition given 1 to 2 days after surgery does not have significant complications, and generally only mild abdominal distension, nausea or diarrhea. The reason for this is that enteral nutrition can directly stimulate intestinal mucosa to proliferate, and serve as a protective barrier to prevent intestinal bacteria ectopy; thus, scholars at home and abroad have consistently emphasized the important role of enteral nutrition and have shown that enteral nutrition is used as much as possible as long as the intestinal function is present.
Generally, diseases, inflammations, viral infections, surgical wounds and adverse environments can cause a series of physiological changes of the organism, which are mainly manifested by hypercatabolism, increased energy consumption, negative nitrogen balance and hypoproteinemia, and immune system problems caused by malnutrition frequently occur due to insufficient nutrients ingested by patients due to the increased energy consumption. After operation, the increase of catabolism of the body can aggravate malnutrition, and the body is in an immunosuppression state due to operation trauma; therefore, it is very important to increase the risk of infection due to low immune function after surgery, improve the nutritional status before and after surgery, and recover the immune function of the body.
Generally, enteral nutrition preparation powder is two types of macromolecular compounds and low molecular monomers according to the degree of pre-digestion, and the dosage form of the special medical purpose formula Food (FSMP) is mostly homogenized and whole protein preparation according to the type of the FSMP (food for special medical purpose formula food) described in the literature, "clinical application adverse reaction analysis of special medical purpose formula food in Sichuan province", accounts for 76.35% in total, and may be related to the higher requirement of the non-essential preparation on the gastrointestinal tract digestion function. However, the short-peptide enteral nutrition still causes adverse reactions, presumably due to its high osmotic pressure. In addition, adverse reactions are easy to occur in patients, which are possibly related to the coexistence of multiple diseases and physical weakness of the patients, particularly the functions of the main organs of the old, such as the heart, the liver, the kidney and the like, are declined to different degrees, so that the metabolic process of the enteral nutrition preparation in vivo is influenced. The elderly postoperative patients have reduced gastric acid secretion, decreased gastric emptying rate, poor gastrointestinal local blood circulation, decreased muscular atrophy absorption area, and degraded food absorption and digestion function. Meanwhile, the sensitivity of nerve ending receptors of the old patients is reduced, the reaction capability of tissues and organs to ingested food is obviously reduced, and special medical foods can also cause discomfort of gastrointestinal tracts.
At present, Oral Nutrition Supplements (ONS) are one of important measures for nutrition support, and are effective, noninvasive, and widely applicable to people, and among patients with adverse reactions (such as abdominal distension, nausea, vomiting, diarrhea, greasiness, poor appetite, and the like), the nutrition support mode still accounts for 77.03% with ONS being more, and patients who use nasogastric and nasointestinal tubes for nutrition support treatment account for 19.59% and 3.38% respectively. Meanwhile, researches show that the types of the nutritional preparations are mostly used in the case of adverse reactions, namely the types of the homogenate and the whole protein preparation account for 76.35 percent.
Under the stress conditions of trauma and operation, the organism is in a high catabolic state, and the metabolism in tissue cells is disordered. Under such conditions, the food ingested by the human body cannot only be considered to supplement the nutrients normally required, but rather to adapt and regulate the metabolic disorders within the tissue cells to maintain the normal metabolism of the cells and the normal structure and function of the tissue organs. However, in the prior art, a few nutritional foods for promoting postoperative rehabilitation have single effect and poor effect, so that the recovery period of a patient is long, and an enteral nutritional food with good effect and short recovery time is urgently needed.
Disclosure of Invention
In order to overcome the problems of the prior art, it is a first object of the present invention to provide an enteral nutritional food.
In order to achieve the purpose, the technical scheme adopted by the invention is as follows:
an enteral nutrition food comprises the following components in parts by weight:
10-40 parts of separated albumen powder, 5-18 parts of freeze-dried fruit powder, 5-20 parts of enzymolysis oat powder, 5-15 parts of MCT powder, 5-18 parts of whole milk powder, 10-30 parts of maltodextrin, 5-18 parts of microwave puffed grains, 3-10 parts of coconut powder, 2-8 parts of instant Ceylon black tea powder, 3-15 parts of solid malt extract, 2-5 parts of low-methoxyl-group pectin, 1-12 parts of fructo-oligosaccharide, 1-5 parts of L-glutamine, 0.6-4 parts of arginine, 3-20 parts of soybean oligopeptide, 0.71091-2.41419 parts of compound vitamin and 0.29103-0.52907 parts of compound mineral substance.
Preferably, the vitamin complex comprises the following components, by weight, 0.001-0.004 parts of retinyl acetate, 0.2-0.4 parts of cholecalciferol, 0.005-0.001 parts of thiamine hydrochloride, 0.0005-0.001 parts of tocopherol acetate, 0.001-0.002 parts of riboflavin, 0.0008-0.0012 parts of pyridoxine hydrochloride, 0.00001-0.00009 parts of cyanocobalamin, 0.5-2 parts of L-ascorbic acid, 0.001-0.002 parts of nicotinamide, 0.001-0.002 parts of nicotinic acid and 0.0006-0.0009 parts of folic acid;
the composite mineral comprises the following components: 0.2 to 0.4 portion of tricalcium phosphate, 0.09 to 0.12 portion of magnesium carbonate, 0.00003 to 0.00007 portion of sodium selenite and 0.001 to 0.009 portion of sodium ferric ethylenediamine tetraacetate.
Preferably, the enteral nutrition food comprises the following components in parts by weight:
15-20 parts of separated albumen powder, 7-14 parts of freeze-dried fruit powder, 7-15 parts of enzymolysis oat powder, 5-10 parts of MCT powder, 5-14 parts of whole milk powder, 13-20 parts of maltodextrin, 5-15 parts of microwave puffed grains, 5-10 parts of coconut powder, 4-11 parts of solid malt extract, soluble dietary fiber, 2-5 parts of low methoxyl pectin, 2-4 parts of instant Ceylon black tea powder, 3-8 parts of fructo-oligosaccharide, 1-3 parts of L-glutamine, 0.8-2 parts of arginine, 4-10 parts of soybean oligopeptide, 0.81332-2.31316 parts of compound vitamin and 0.39104-0.51906 parts of compound mineral substance;
the compound vitamin comprises the following components of 0.002-0.003 part of retinyl acetate, 0.2-0.3 part of cholecalciferol, 0.006-0.001 part of thiamine hydrochloride, 0.0006-0.001 part of tocopherol acetate, 0.001-0.002 part of riboflavin, 0.0010-0.0012 part of pyridoxine hydrochloride, 0.00002-0.00006 part of cyanocobalamin, 0.6-2 parts of L-ascorbic acid, 0.001-0.002 part of nicotinamide, 0.001-0.002 part of nicotinic acid and 0.0007-0.0009 part of folic acid;
the composite mineral comprises the following components: 0.3 to 0.4 portion of tricalcium phosphate, 0.09 to 0.11 portion of magnesium carbonate, 0.00004 to 0.00006 portion of sodium selenite and 0.001 to 0.009 portion of sodium ferric ethylenediamine tetraacetate.
Preferably, the selenium element in the compound mineral can also be provided by 0.05-0.1 part of selenium-enriched yeast.
Preferably, the soluble dietary fiber contained in the low methoxyl pectin and the fructo-oligosaccharide can also be provided by other substances: 3-8 parts of inulin, 1-3 parts of xylo-oligosaccharide, 1-3 parts of soybean oligosaccharide, 1-3 parts of resistant starch, 1-3 parts of resistant dextrin and any two or more of polydextrose.
Preferably, the insoluble dietary fiber contained in the microwave puffed cereal, the enzymatic oat and the freeze-dried fruit powder can also be provided by other substances: 1-2 parts of resistant dextrin, 5-18 parts of oat fiber, 1-5 parts of wheat fiber and 1-5 parts of soybean fiber.
Preferably, the microwave puffed grain is any one or more of puffed rice flour, puffed brown rice flour, puffed purple sweet potato powder and puffed potato powder; the esterification degree of the low methoxyl pectin is less than 50%.
The second purpose of the invention is to provide a preparation method of enteral nutrition food, which comprises the following steps of S1, adding separated albumen powder, freeze-dried fruit powder, enzymolysis oat powder, MCT powder, whole milk powder, maltodextrin, microwave puffed grains, coconut powder, Ceylon instant black tea powder, solid malt extract, low methoxyl pectin, fructo-oligosaccharide, L-glutamine, arginine and soybean oligopeptide into a stirrer together for fully mixing to obtain a mixture;
step S2: crushing the mixture obtained in the step S1 to obtain mixed powder with the particle size of 100-120 meshes;
step S3: sterilizing the mixed powder obtained in step S2;
step S4: spray drying and screening the mixed powder sterilized in the step S3 to obtain mixed powder with the water content of 3-5% and the grain size of less than 100 meshes;
step S5: cooling the mixed powder obtained in the step S4 to normal temperature, and then adding the compound vitamin and the compound mineral into the cooled mixed powder to finally obtain the enteral nutrition food with the mass content of carbohydrate of 45-55%, the mass content of protein of 25-35% and the mass content of fat of 25-30%;
step S6: and (4) filling nitrogen to package the enteral nutrition food obtained in the step (S5) at normal temperature and with the relative humidity of 35-70%.
Preferably, the sterilization manner in step S3 is irradiation of radiation, and the drying conditions in step S4 are: the air inlet temperature is 90-200 ℃, and the air outlet temperature is 60-120 ℃.
A third object of the present invention is to apply enteral nutrition to general surgery patients.
Compared with the prior art, the invention has the following beneficial effects:
(1) according to the invention, by enriching the types of enteral nutrition foods, such as adding microwave puffed grains, enzymolysis oat powder, freeze-dried fruit powder, sugar-free coconut powder, inulin and the like, on one hand, stomach discomfort caused by the change of food sources in a short period of time of a patient is relieved, satiety is enhanced, and the recovery of stomach function is promoted; on the other hand, the purposes of improving the gastrointestinal compliance of patients, enhancing the digestion and absorption functions and improving the nutritional status of the patients so as to reduce the hospitalization time are achieved, and the wound healing time of the patients taking the enteral nutrition food prepared by the invention is found to be at least 2 days shorter than that of the patients taking the common enteral nutrition food in clinic. In addition, the invention also reduces the occurrence of gastrointestinal adverse reactions by adding low methoxyl pectin (the esterification degree is lower than 50 percent) and the bridging effect of multivalent cations and adjusting the proportion of soybean oligopeptide, fructo-oligosaccharide, inulin and the like in the enteral nutrition food, thereby better realizing the enteral nutrition supplement and treatment.
(2) The low methoxyl pectin in the enteral nutrition food disclosed by the invention is combined with free calcium ions decomposed from tricalcium phosphate in the gastric acid environment, so that an ion-combined semi-solidified chyme-shaped gel is formed, the feeding effect of normal food can be simulated, the proper gastric emptying time is ensured, and the common adverse reactions of enteral nutrition preparations such as acid regurgitation, diarrhea and the like are prevented. In addition, the insoluble dietary fibers rich in the natural food raw materials such as the microwave puffed grains, the enzymolysis oat, the freeze-dried fruit powder, the inulin and the like increase the water content and the volume of food, so that the excrement normally passes through the intestine to promote the generation of soft excrement and reduce the postoperative intestinal pressure. In addition, insoluble dietary fibers contained in the microwave puffed grains, the enzymolysis oat, the freeze-dried fruit powder and the inulin increase gastrointestinal viscosity, so that emptying time is prolonged, esophagus reflux and vomiting are prevented, patients can have good satiety and moderate energy density after eating the formula food, and the enteral nutrient substance can meet continuous energy supply for 3-4 hours in the practical application process.
(3) The protein in the invention is separated whey protein, on one hand, the bioavailability of the whey protein is fully exerted, and on the other hand, the immune globulin and the lactoferrin in the separated whey protein have the immune activity and the anti-oxidation property and can improve the immunity of the organism.
(4) The fructo-oligosaccharide and inulin prebiotics of the present invention are resistant to enzymatic digestion in the upper gastrointestinal tract, reach the colon intact and undergo bacterial fermentation, thereby promoting the balance of intestinal microbiota in patients undergoing general surgery.
(5) MCT in the invention is a medium chain triglyceride, which can be absorbed without pancreatic secretion due to small molecular weight, does not need to form celiac particles with other lipid substances during absorption, is not easy to combine with protein, and directly enters liver through portal vein without lymphatic system. In addition, the substance can be hydrolyzed and removed from circulation more quickly, does not affect the level of blood triacylglycerol, has little influence on liver function, greatly improves the tolerance of patients after liver operation, and is suitable for diseases such as fat hydrolysis, chylomicronemia, most of small intestine excision, intestinal lipodystrophy and the like.
(6) The interaction of the compound vitamin and the compound mineral substances in the invention helps the muscle growth and prevents the muscle mass consumption on one hand, and improves the muscle mass recovery on the other hand, promotes the postoperative rehabilitation and reduces the hospitalization time.
(7) The enteral nutrition food prepared by the preparation method ensures the sanitation and comfortable mouthfeel of the enteral nutrition food through mixing, sterilization and sieving, and the compound vitamin and the compound mineral substance are added at normal temperature to prevent the compound microorganism and the compound mineral substance of the enteral nutrition food from being damaged at high temperature and reduce the effects of the compound vitamin and the compound mineral substance; and packaging the enteral nutrition food in a nitrogen-filled mode to obtain loose and porous infusion type liquid diet.
Detailed Description
Freeze-drying fruit powder:
the freeze-dried fruit powder is a mixed powdery substance obtained by freeze-drying any one or more fruits, and the preparation process comprises the following steps:
firstly, selecting fresh fruits, carrying out ultrasonic cleaning, and then sequentially carrying out wall breaking crushing, multi-stage separation, primary concentration, vacuum low-temperature drying, primary crushing and superfine crushing to obtain freeze-dried fruit powder.
The freeze-dried fruit powder obtained by the preparation process does not retain the bioactive components and the nutritive value of fruits, and has the characteristics of good solubility, dispersibility and rehydration property.
Enzymolysis of oat flour:
the preparation process of the substance with β -glucan content of 4.2-6.6% and protein content of 11-15% in the enzymolysis oat powder comprises the following steps:
firstly, oat is peeled, and then sequentially subjected to microwave enzyme deactivation, enzymolysis, centrifugal separation, precipitate drying and superfine grinding to obtain enzyme-hydrolyzed oat powder.
The enzymolysis oat flour obtained by the preparation process has the characteristics of quick rehydration, good solubility and easy digestion and absorption.
Soybean oligopeptide:
the soybean oligopeptide disclosed by the invention has the protein content of 86.98%, the fat content of 0.04%, the water content of 4.73% and the ash content of 5.08%.
Puffing grains by microwave:
the microwave puffed grain in the invention is any one or more of puffed rice flour, puffed brown rice flour, puffed purple sweet potato powder and puffed potato powder. The instant nutrient has the characteristics of excellent flavor, quick rehydration and high retention of instant nutrient components, and the preparation process comprises the following steps:
the microwave puffed grain is obtained by sequentially carrying out cleaning, cooking, softening treatment, pulping, colloid mill refining and homogenizing, roller drying or microwave puffing and secondary drying on the grain.
MCT:
The MCT in the present invention are medium chain triglycerides, typically derived from rice oil, olive oil, tea oil, linseed oil, coconut oil.
Examples
The technical solution of the present invention will be further clearly and completely described with reference to the following examples, wherein the raw materials used in the examples of the present invention are all commercially available.
Example 1
An enteral nutrition food comprises the following components in parts by weight:
10 parts of separated albumen powder, 5 parts of freeze-dried banana powder, 5 parts of enzymolysis oat powder, 5 parts of MCT powder, 5 parts of full cream milk powder, 10 parts of maltodextrin, 5 parts of microwave puffed grain, 3 parts of coconut powder, 2 parts of Ceylon instant black tea powder, 3 parts of solid malt extract, 2 parts of low methoxyl pectin, 1 part of fructo-oligosaccharide, 1 part of L-glutamine, 0.6 part of arginine, 3 parts of soybean oligopeptide, 0.001 part of retinyl acetate, 0.2 part of cholecalciferol, 0.005 part of thiamine hydrochloride, 0.0005 part of tocopheryl acetate, 0.001 part of riboflavin, 0.0008 part of pyridoxine hydrochloride, 0.00001 part of cyanocobalamine, 0.5 part of L-ascorbic acid, 0.001 part of nicotinamide, 0.001 part of nicotinic acid, 0.0006 part of folic acid, 0.2 part of tricalcium phosphate, 0.09 part of magnesium carbonate, 0.00003 part of sodium selenite and 0.001 part of sodium iron ethylenediaminetetraacetate.
The preparation method specifically comprises the following preparation steps:
step 1, feeding 10 parts of separated albumen powder, 5 parts of freeze-dried banana powder, 5 parts of enzymolysis oat powder, 5 parts of MCT powder, 5 parts of whole milk powder, 10 parts of maltodextrin, 5 parts of microwave puffed grain, 3 parts of coconut powder, 2 parts of instant Ceylon black tea powder, 3 parts of solid malt extract, 2 parts of low-methoxyl-group pectin, 1 part of fructo-oligosaccharide, 1 part of L-glutamine, 0.6 part of arginine and 3 parts of soybean oligopeptide into a V-shaped mixer, and fully mixing in the V-shaped mixer to obtain a mixture.
Step 2: and (3) feeding the mixture obtained in the step (1) into a pulverizer, and pulverizing the mixture into 120-mesh mixed powder with the particle size of 100-.
And step 3: and (3) sterilizing the mixed powder obtained in the step (2) by using 5-10kGy of irradiation rays.
And 4, step 4: spray-drying the mixed powder sterilized in the step (3) by adopting a pressure type spray dryer device and screening the powder to obtain the mixed powder with the water content of 3-5% and the particle size of less than 100 meshes, wherein the spray-drying conditions are as follows: the air inlet temperature is 90-200 ℃, and the air outlet temperature is 60-120 ℃.
And 5, cooling the mixed powder obtained in the step 4 to normal temperature, and then adding 0.001 part of retinyl acetate, 0.2 part of cholecalciferol, 0.005 part of thiamine hydrochloride, 0.0005 part of tocopherol acetate, 0.001 part of riboflavin, 0.0008 part of pyridoxine hydrochloride, 0.00001 part of cyanocobalamin, 0.5 part of L-ascorbic acid, 0.001 part of nicotinamide, 0.001 part of nicotinic acid, 0.0006 part of folic acid, 0.2 part of tricalcium phosphate, 0.09 part of magnesium carbonate, 0.00003 part of sodium selenite and 0.001 part of sodium iron ethylenediaminetetraacetate into the cooled mixed powder to finally obtain the enteral nutrition food with the mass content of carbohydrate of 45-55%, the mass content of protein of 25-35% and the mass content of fat of 25-30%.
Step 6: and (5) filling nitrogen into the enteral nutrition food obtained in the step (5) under the conditions of normal temperature and relative humidity of 35-70%, and packaging to obtain the enteral nutrition food which is loose, porous, strong in water solubility, rich in taste and sufficient in nutrition and is mixed with powdery brewing type liquid diet.
Example 2
An enteral nutrition food comprises the following components in parts by weight:
18 parts of separated albumen powder, 12 parts of freeze-dried banana powder, 12 parts of enzymolysis oat powder, 10 parts of MCT powder, 6 parts of full cream milk powder, 15 parts of maltodextrin, 5 parts of solid malt extract, 5 parts of low methoxyl pectin, 8 parts of fructo-oligosaccharide, 6 parts of puffed purple sweet potato powder, 5 parts of coconut powder, 2.5 parts of Ceylon instant black tea powder, 2 parts of L-glutamine, 1.5 parts of arginine, 8 parts of soybean oligopeptide, 0.003 part of retinyl acetate, 0.2 part of cholecalciferol, 0.001 part of thiamine hydrochloride, 0.001 part of tocopherol acetate, 0.002 part of riboflavin, 0.0012 part of pyridoxine hydrochloride, 0.00006 part of cyanocobalamin, 2 parts of L-ascorbic acid, 0.002 part of nicotinamide, 0.002 part of nicotinic acid, 0.0009 part of folic acid, 0.3 part of tricalcium phosphate, 0.09 part of magnesium carbonate, 0.00004 part of sodium selenite and 0.009 part of ferric ethylene diamine tetraacetate.
The preparation method of the enteral nutrition food was carried out according to the preparation procedure of the enteral nutrition food in example 1.
Example 3
An enteral nutrition food comprises the following components in parts by weight:
40 parts of separated albumen powder, 18 parts of freeze-dried banana powder, 20 parts of enzymolysis oat powder, 15 parts of MCT powder, 18 parts of full cream milk powder, 30 parts of maltodextrin, 18 parts of puffed purple sweet potato powder, 10 parts of coconut powder, 8 parts of Ceylon instant black tea powder, 15 parts of solid malt extract, 5 parts of low methoxyl pectin, 12 parts of fructo-oligosaccharide, 5 parts of L-glutamine, 4 parts of arginine, 20 parts of soybean oligopeptide, 0.004 part of retinyl acetate, 0.4 part of cholecalciferol, 0.001 part of thiamine hydrochloride, 0.001 part of tocopherol acetate, 0.002 part of riboflavin, 0.0012 part of pyridoxine hydrochloride, 0.00009 part of cyanocobalamine, 2 parts of L-ascorbic acid, 0.002 part of nicotinamide, 0.002 part of nicotinic acid, 0.0009 part of folic acid, 0.4 part of tricalcium phosphate, 0.12 part of magnesium carbonate, 0.00007 part of sodium selenite and 0.009 part of sodium ethylene diamine tetraacetate.
The preparation method of the enteral nutrition food was carried out according to the preparation procedure of the enteral nutrition food in example 1.
Example 4
An enteral nutrition food comprises the following components in parts by weight:
22 parts of isolated whey protein powder, 10 parts of whole milk powder, 8 parts of soybean oligopeptide, 10 parts of MCT powder, 15 parts of freeze-dried banana powder, 12 parts of enzymolysis oat powder, 8 parts of maltodextrin, 4 parts of solid malt extract, 3 parts of low methoxyl pectin, 3 parts of fructo-oligosaccharide, 2 parts of inulin, L-glutamine 2 parts, 1.5 parts of arginine, 0.003 part of retinyl acetate, 0.001 part of thiamine hydrochloride, 0.001 part of tocopherol acetate, 0.002 part of riboflavin, 0.0012 part of pyridoxine hydrochloride, 0.00006 part of cyanocobalamine, 2 parts of L-ascorbic acid, 0.002 part of nicotinamide, 0.002 part of nicotinic acid, 0.0009 part of folic acid, 0.3 part of tricalcium phosphate, 0.09 part of magnesium carbonate, 0.00004 part of sodium selenite, 0.009 part of ferric sodium ethylenediamine tetraacetic acid and 0.2 part of calcium.
The preparation method of the enteral nutrition food was carried out according to the preparation procedure of the enteral nutrition food in example 1.
Example 5
The enteral nutrient prepared in example 4 was applied to patients who were subjected to general surgery and studied.
Study subjects: 100 patients who received laparoscopic gastric cancer surgery in 2018 to 2019, month 7, 43 men and 57 women, age 18-70, and average age 40.8 ± 5.3. In addition, patients were subjected to a nutritional risk screening score (NRS score) according to the NRS-2002 scoring sheet recommended by the European Nutrition society. The NRS score is more than or equal to 3, the nutrition risk is considered to be positive, meanwhile, the corresponding laparoscopic surgery treatment is carried out according to the tumor position of the patients, and the treatment intervention of the two groups of patients is completed by the same group of doctors.
The nutrition treatment method comprises the following steps:
1. 100 patients were randomized into experimental (n-50) and control (n-50) groups, with no statistical significance for sex ratio, age, mode of surgery, and differences in preoperative nutritional status (P value > 0.05).
2. The patients in the experimental group and the control group were subjected to nutritional supplementation, wherein the nutritional formulation used in the experimental group was the enteral nutritional food prepared in example 4, and the nutritional formulation used in the control group was an equal-protein energy food composed of whey protein and maltodextrin.
Experimental groups:
nutritional support protocol for preoperative experimental groups: 900ml of the enteral nutrition food prepared in example 4 was orally taken after fasting one day before surgery as a nutritional support before surgery.
Postoperative experimental group nutritional support protocol enteral nutritional food prepared in example 4 was administered as nutritional support (1/2 for which the body normally requires energy) on the day of surgery, × 2 times of the mixed solution of enteral nutritional food prepared in example 4 (82g powder +300 water) was administered on day 1 after surgery, the mixed solution was increased to × 3 times on day 2 after surgery, (82g powder +300 water) × 4 times of the mixed solution was administered on day 3 after surgery while instructing the patient to start voluntary drinking water and a small amount of liquid food, the same parenteral nutritional support was administered on days 4, 5 and 3 after surgery, and half-fluid diet and regular diet were gradually changed on day 4.
Control group:
preoperative and postoperative nutrition support regimens: the patients with positive nutritional risk in the control group are given foods with equal protein energy, and the energy and the nitrogen amount obtained by the two groups of patients at the same time are not obviously different.
The observation indexes comprise nutrition indexes of 1 day before operation, 3 days after operation and 5 days after operation of a comparison experiment group and a control group, namely body mass index (BMI index), albumin (A L B) and Prealbumin (PA), immune function indexes of lymphocyte count (L Y), leukocyte count (WBC), C-reactive protein (CRP, serum immunoglobulin IgA and IgG), and gastrointestinal tract recovery condition, operation complication and gastrointestinal intolerance occurrence condition (gastroesophageal acid regurgitation, diarrhea, abdominal distension and hypodynamia) are observed at the same time.
The experimental results are as follows:
TABLE 1.100 nutritional index for perioperative period of patients
TABLE 2.100 patients' perioperative period different treatment immune index
TABLE 3.100 patients' perioperative period different nutritherapy wound healing index
Group of | n (human) | Show effect | Recovery method | Invalidation | Effective rate (%) | Time to wound healing |
Experimental group | 50 | 21 | 28 | 1 | 98 | 6.5±2.5 |
Control group | 50 | 15 | 19 | 16 | 68** | 8.5±3** |
Table 4.00 patients' incidence of adverse reactions in perioperative period by different nutrition therapy
Adverse reaction | Experimental group | Control group | p value |
Counter acid | 3 | 17 | <0.01 |
Abdominal distention | 5 | 13 | <0.01 |
Diarrhea (diarrhea) | 3 | 19 | <0.01 |
Debilitation | 7 | 26 | <0.01 |
Note: p <0.05, p <0.01, with significant differences below a p value of 0.05;
perioperative period is preoperative + postoperative.
As seen from tables 1 and 2, the nutritional indices: the BMI index and the albumin nutrition index of two groups of patients 1 day before operation are compared, and the difference has no statistical significance (p value is more than 0.05); but the experimental group had higher prealbumin levels than the control group and the difference was statistically significant (p-value < 0.05); both groups of patients had increased albumin and prealbumin levels compared to the previous but the difference was not statistically significant on day 3 post-surgery (p-value > 0.05); on the 5 th day after operation, the albumin and prealbumin levels of the two groups of patients are obviously increased compared with those before operation, and the increase of the albumin level of the experimental group has statistical significance compared with the difference of the control group (the p value is less than 0.05); the BMI index changes at each time interval, and the difference has no statistical significance.
As can be seen from table 3, the effective rate of wound healing in the experimental group was significantly higher than that in the control group (p-value <0.05), and the healing time was significantly lower than that in the control group (p-value < 0.05). According to table 4, the incidence of adverse reactions in the experimental group was significantly lower than that in the control group (p-value <0.01), and it was concluded that the enteral nutritional food prepared according to the present invention contributes to the wound healing of the patients who were operated, and can significantly prevent the occurrence of gastrointestinal distress in the patients.
In summary, the present invention solves the technical deficiencies of the prior art. According to the invention, by enriching the types of enteral nutrition foods, such as adding microwave puffed grains, enzymolysis oat powder, freeze-dried fruit powder, sugar-free coconut powder, inulin and the like, on one hand, stomach discomfort caused by the change of food sources in a short period of time of a patient is relieved, satiety is enhanced, and the recovery of stomach function is promoted; on the other hand, the gastrointestinal compliance of the patient is improved, the digestion and absorption functions are enhanced, and the nutritional status of the patient is improved, so that the aim of reducing the hospitalization time is fulfilled. In addition, the invention also reduces the occurrence of gastrointestinal adverse reactions by adding low methoxyl pectin (the esterification degree is lower than 50 percent) and the bridging effect of multivalent cations and adjusting the proportion of soybean oligopeptide, fructo-oligosaccharide, inulin and the like in the enteral nutrition food, thereby better realizing the enteral nutrition supplement and treatment.
The foregoing is only a partial embodiment of the present invention, and it should be noted that, for those skilled in the art, various modifications and decorations can be made without departing from the principle of the present invention, and these modifications and decorations should also be regarded as the protection scope of the present invention.
Claims (10)
1. An enteral nutrition food is characterized by comprising the following components in parts by weight:
10-40 parts of separated albumen powder, 5-18 parts of freeze-dried fruit powder, 5-20 parts of enzymolysis oat powder, 5-15 parts of MCT powder, 5-18 parts of whole milk powder, 10-30 parts of maltodextrin, 5-18 parts of microwave puffed grains, 3-10 parts of coconut powder, 2-8 parts of instant Ceylon black tea powder, 3-15 parts of solid malt extract, 2-5 parts of low-methoxyl-group pectin, 1-12 parts of fructo-oligosaccharide, 1-5 parts of L-glutamine, 0.6-4 parts of arginine, 3-20 parts of soybean oligopeptide, 0.71091-2.41419 parts of compound vitamin and 0.29103-0.52907 parts of compound mineral substance.
2. The enteral nutritional food according to claim 1, wherein the multivitamins are composed of, by weight, 0.001-0.004 parts of retinyl acetate, 0.2-0.4 parts of cholecalciferol, 0.005-0.001 parts of thiamine hydrochloride, 0.0005-0.001 parts of tocopherol acetate, 0.001-0.002 parts of riboflavin, 0.0008-0.0012 parts of pyridoxine hydrochloride, 0.00001-0.00009 parts of cyanocobalamin, 0.5-2 parts of L-ascorbic acid, 0.001-0.002 parts of niacinamide, 0.001-0.002 parts of nicotinic acid, 0.0006-0.0009 parts of folic acid;
the composite mineral comprises the following components: 0.2 to 0.4 portion of tricalcium phosphate, 0.09 to 0.12 portion of magnesium carbonate, 0.00003 to 0.00007 portion of sodium selenite and 0.001 to 0.009 portion of sodium ferric ethylenediamine tetraacetate.
3. The enteral nutritional food according to claim 2, which comprises the following components in parts by weight:
15-20 parts of separated albumen powder, 7-14 parts of freeze-dried fruit powder, 7-15 parts of enzymolysis oat powder, 5-10 parts of MCT powder, 5-14 parts of whole milk powder, 13-20 parts of maltodextrin, 5-15 parts of microwave puffed grains, 5-10 parts of coconut powder, 4-11 parts of solid malt extract, soluble dietary fiber, 2-5 parts of low methoxyl pectin, 2-4 parts of instant Ceylon black tea powder, 3-8 parts of fructo-oligosaccharide, 1-3 parts of L-glutamine, 0.8-2 parts of arginine, 4-10 parts of soybean oligopeptide, 0.81332-2.31316 parts of compound vitamin and 0.39104-0.51906 parts of compound mineral substance;
the compound vitamin comprises the following components of 0.002-0.003 part of retinyl acetate, 0.2-0.3 part of cholecalciferol, 0.006-0.001 part of thiamine hydrochloride, 0.0006-0.001 part of tocopherol acetate, 0.001-0.002 part of riboflavin, 0.0010-0.0012 part of pyridoxine hydrochloride, 0.00002-0.00006 part of cyanocobalamin, 0.6-2 parts of L-ascorbic acid, 0.001-0.002 part of nicotinamide, 0.001-0.002 part of nicotinic acid and 0.0007-0.0009 part of folic acid;
the composite mineral comprises the following components: 0.3 to 0.4 portion of tricalcium phosphate, 0.09 to 0.11 portion of magnesium carbonate, 0.00004 to 0.00006 portion of sodium selenite and 0.001 to 0.009 portion of sodium ferric ethylenediamine tetraacetate.
4. An enteral nutritional food according to any one of claims 1 to 3, wherein the selenium in the complex minerals is also provided by 0.05 to 0.1 parts of selenium enriched yeast.
5. An enteral nutritional food according to any one of claims 1 to 3 wherein the soluble dietary fibre contained in the low methoxyl pectin and fructo-oligosaccharides is provided by other means: 3-8 parts of inulin, 1-3 parts of xylo-oligosaccharide, 1-3 parts of soybean oligosaccharide, 1-3 parts of resistant starch, 1-3 parts of resistant dextrin and any two or more of polydextrose.
6. An enteral nutritional food according to any one of claims 1 to 3 wherein the insoluble dietary fibre contained in the microwave puffed cereal, enzymatically digested oat, freeze dried fruit powder is further provided by other means: 1-2 parts of resistant dextrin, 5-18 parts of oat fiber, 1-5 parts of wheat fiber and 1-5 parts of soybean fiber.
7. An enteral nutritional food according to any one of claims 1 to 3 wherein the microwave puffed cereal is any one or more of puffed rice flour, puffed brown rice flour, puffed purple potato flour, puffed potato flour; the esterification degree of the low methoxyl pectin is less than 50%.
8. A method for preparing an enteral nutritional food according to any one of claims 1 to 7, comprising the steps of:
step S1, adding the separated albumen powder, the freeze-dried fruit powder, the enzymolysis oat powder, the MCT powder, the whole milk powder, the maltodextrin, the microwave puffed grain, the coconut powder, the stannum instant black tea powder, the solid malt extract, the low methoxyl pectin, the fructo-oligosaccharide, L-glutamine, the arginine and the soybean oligopeptide into a stirrer together for fully mixing to obtain a mixture;
step S2: crushing the mixture obtained in the step S1 to obtain mixed powder with the particle size of 100-120 meshes;
step S3: sterilizing the mixed powder obtained in step S2;
step S4: spray drying and screening the mixed powder sterilized in the step S3 to obtain mixed powder with the water content of 3-5% and the grain size of less than 100 meshes;
step S5: cooling the mixed powder obtained in the step S4 to normal temperature, and then adding the compound vitamin and the compound mineral into the cooled mixed powder to finally obtain the enteral nutrition food with the mass content of carbohydrate of 45-55%, the mass content of protein of 25-35% and the mass content of fat of 25-30%;
step S6: and (4) filling nitrogen to package the enteral nutrition food obtained in the step (S5) at normal temperature and with the relative humidity of 35-70%.
9. The method of claim 8, wherein the sterilization in step S3 is irradiation, and the drying conditions in step S4 are: the air inlet temperature is 90-200 ℃, and the air outlet temperature is 60-120 ℃.
10. Use of an enteral nutritional product according to any one of claims 1 to 7 in general surgery patients.
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