High total bilirubin and unconjugated bilirubin need to be treated with splenectomy and glucocorticoids according to the different causes such as non-pathological causes, hemolytic diseases, medication and hereditary causes. 1. Non-pathological causes: prolonged fasting and frequent starvation may lead to high total and unconjugated bilirubin, which usually do not require special treatment. 2. Hemolytic diseases: (1) Congenital factors: such as spherocytosis, glucose-6-phosphate dehydrogenase deficiency, sickle cell anemia, etc. Glucocorticoids and splenectomy are needed for treatment. (2) Acquired factors: Acquired hemolytic disorders such as paroxysmal sleep hemoglobinuria, immune anemia, and macrohematoma resorption need to be treated with glucocorticoids and blood transfusion. 3. Pharmacological: rifampicin, chloramphenicol, furotoxin, ethinyl estradiol, ribavirin, etc. may lead to high total bilirubin and unconjugated bilirubin, which may be considered to discontinue or change the medication. 4. Hereditary: such as Gilbert’s syndrome, certain enzyme (e.g. glucuronosyltransferase) deficiencies, resulting in the generation of unconjugated bilirubin can not be metabolized, can be taken to reduce the bilirubin phenobarbital and other enzyme inducers. 5. Other causes: heart failure, hyperthyroidism, parasitic infections such as malaria, may lead to high total and unconjugated bilirubin, and require active treatment of the primary disease. Total bilirubin and unconjugated bilirubin may be high for other reasons, it is recommended to consult the doctor in time, improve the relevant examination to clarify the cause of the disease, and then carry out targeted treatment to avoid adverse consequences.