Monocular 3D object detection has attracted great attention due to simplicity and low cost. Existing methods typically follow conventional 2D detection paradigms, first locating object centers and then predicting 3D attributes via neighboring features. However, these methods predominantly rely on progressive cross-scale feature aggregation and focus solely on local information, which may result in a lack of global awareness and the omission of small-scale objects. In addition, due to large variation in object scales across different scenes and depths, inaccurate receptive fields often lead to background noise and degraded feature representation. To address these issues, we introduces MonoASRH, a novel monocular 3D detection framework composed of Efficient Hybrid Feature Aggregation Module (EH-FAM) and Adaptive Scale-Aware 3D Regression Head (ASRH). Specifically, EH-FAM employs multi-head attention with a global receptive field to extract semantic features for small-scale objects and leverages lightweight convolutional modules to efficiently aggregate visual features across different scales. The ASRH encodes 2D bounding box dimensions and then fuses scale features with the semantic features aggregated by EH-FAM through a scale-semantic feature fusion module. The scale-semantic feature fusion module guides ASRH in learning dynamic receptive field offsets, incorporating scale priors into 3D position prediction for better scale-awareness. Extensive experiments on the KITTI and Waymo datasets demonstrate that MonoASRH achieves state-of-the-art performance.